UC-NRLF 


B    3    DOS    715 


ARCHIBALD  CHUR' 
LIBRARY 


NORTHWESTERN  UNIVERSITY 
MEDICAL  SCHOOL 


s 


A 


THE  LIBRARY 

OF 

THE  UNIVERSITY 
OF  CALIFORNIA 


PRESENTED  BY 

PROF.  CHARLES  A.  KOFOID  AND 
MRS.  PRUDENCE  W.  KOFOID 


• 


S 


•  v 


-*t     * 


V 


SPECIAL    ANATOMY 


AND 


HISTOLOGY 


BY 

WILLIAM   E.  JIORNER,  M.D., 

PROFESSOR  OF  ANATOMY,  UNIVERSITY  OF  PENNSYLVANIA  |    SENIOR  SURGEON,  SAINT  JOSEPH'S 
HOSPITAL  J    MEMBER  OF  THE  ACADEMY  OF  NATURAL  SCIENCES  OF  PHILADELPHIA  J 

ETC.  ETC. 


Multum  adhuc  restat  operis,  raultumque  restabit,  nee  ulli  nato,  post  mille  ssecula  proecluditur  occasio 
aliquidadjiciendi.  SEXECA,  EPIST. 


EIGHTH   EDITION. 

ILLUSTRATED   WITH  ANATOMICAL  FIGURES. 

IN   TWO   VOLUMES. 
VOL.  I. 


PHILADELPHIA: 

BLANCHAKD    AND    LEA 

1851. 


C  ( A/U 


Entered  according  to  the  Act  of  Congress,  in  the  year  1851,  by 

WILLIAM  E.  HORNER, 
in  the  Office  of  the  Clerk  of  the  District  Court  for  the  Eastern  District  of  Pennsylvania. 


PHILADELPHIA  : 
T.  K.  AND  P.  G.  COLLINS,  PRINTERS. 


lib  raw 

DEDICATION  OF  THE  SIXTH  EDITION. 


TO 

NATHANIEL   CHAPMAN,  M.  D., 

PROFESSOR   OF   THE   PRACTICE   OF  MEDICINE   IN  THE   UNIVERSITY   OF   PENNSYLVANIA. 

MY  DEAR  SIR  : 

From  the  new  aspect  which  it  has  assumed,  I  take  the 
liberty  of  dedicating  to  you  the  following  TREATISE  ON  ANA- 
TOMY, heretofore  without  the  patronage  of  an  illustrious  name. 
That  this  is  done  in  the  spirit  of  disinterested  friendship  and 
esteem,  is  manifested  by  the  different  paths  of  professional 
occupation  that  we  have  followed.  I  have  felt  the  act  as  an 
imperative  duty  from  the  efficient  encouragement  in  my  early 
years  so  copiously  lavished  by  yourself;  and  without  which 
my  course  of  life  would,  in  all  probability,  have  been  very 
different,  and  much  less  satisfactory  to  myself.  That  a  life 
rendered  valuable  by  talents  of  no  common  order;  by  the 
kindest  and  most  generous  of  feelings ;  and  so  usefully  em- 
ployed as  yours  in  mitigating  the  ills  of  human  existence,  may 
be  long  preserved  in  its  present  undiminished  vigor  of  mind 
and  body  is  the  sincere  prayer  of, 

Your  obedient  servant  and  friend, 

W.  K  HORNER. 

PHILADELPHIA,  Sept.  1st,  1843. 


A 


PREFACE  TO  THE  SEVENTH  EDITION- 


IN  presenting  to  the  profession  a  seventh  Edition  of  his  work  on 
Special  Anatomy  and  Histology,  the  Author  remarks,  that  it  is  not  a 
mere  reprint  of  the  last  edition,  published  three  years  ago,  which  itself 
contained  copious  additions  over  its  predecessors ;  but  that  it  has  un- 
dergone several  modifications,  and  many  extensions,  derived  from  the 
progressive  state  of  the  science  of  anatomy.  Where  everything  else 
declares  such  energy  in  the  cultivation  of  medicine,  it  was  not  to  be 
expected  that  a  branch  so  distinguished  in  modern  times  by  the  inde- 
fatigable zeal  of  its  votaries,  should  remain  stationary;  anatomy  ac- 
cordingly, though  the  most  settled  of  all  the  branches,  has  not  been  idle 
during  the  interval  alluded  to,  but  has  been  enriched  by  absolutely 
new  and  by  more  perfect  observations. 

A  comparison  of  the  present  edition  with  its  antecedents  will,  there- 
fore, the  Author  hopes,  show  to  the  student  an  improved  state,  in  many 
respects,  in  regard  both  to  Descriptive  Anatomy  and  to  Histology : 
much  of  the  latter,  especially,  having  been  remodelled  and  written  anew 
since  the  last  edition. 

The  present  edition  has  also  the  advantage  of  additional  illustrations 
from  the  best  authorities,  through  numerous  figures  inserted  upon  its 
pages:  and  it  is  placed  in  a  more  immediate  relation  with  the  volume 
of  Plates,  by  Dr.  H.  H.  Smith,  called  Anatomical  Atlas ;  they  having 
been  selected  expressly  as  an  elucidation  of  its  text.  This  connection 
has  been  done  by  specific  references  at  the  foot  of  the  page  to  the  Plates 
in  question. 

That  all  has  been  said  which  belongs  to  the  science  of  Anatomy,  no 
one  fully  acquainted  with  the  subject  will  admit:  but  the  Author  trusts 
that  no  well-established  fact  of  leading  importance  has  been  omitted ; 
and  that  a  sufficient  expansion  has  been  given  to  the  subject  to  realize 
the  principal  object,  that  of  furnishing  an  elementary  Text  Book  for 
the  use  of  students  of  Medicine, 

Within  the  reminiscences  of  the  Author  some  decided  epochs  have 
occurred  in  the  cultivation  of  Anatomy.  At  the  first  appearance  of 


Vi  PREFACE  TO  THE  SEVENTH  EDITION. 

this  work,  which  was  in  1826,  Descriptive  Anatomy  made  up  almost 
the  whole  science,  as  taught  in  the  schools.  General  Anatomy  was 
known  but  little  more  than  by  name  in  this  country ;  and  in  our  parent 
country  had  not  advanced  equally  far,  in  scientific  notice.  It  was 
strange  almost  everywhere  to  British  ears,  notwithstanding  the  saga- 
city and  quickness  to  improvement  of  that  eminent  nation ;  and  by  some 
of  its  distinguished  teachers  was  professedly  derided.  Its  familiarity, 
at  present,  with  both  sides  of  the  Atlantic,  marks  the  solidity  of  the 
basis  upon  which  it  is  founded,  and  the  immense  acquisition  it  has  been 
to  pathology  and  to  physiology ;  its  actual  state  has  fully  justified  the 
prominent  position  in  which  it  was  placed  in  my  first  edition.  The 
same  deference  then  felt  for  this  rich  and  inviting  branch  of  Anatomy 
has  been  retained  by  me  to  the  present  day ;  and  the  subject  is  again 
presented  vastly  improved  in  accuracy  and  augmented  in  observations, 
by  perfections  in  the  construction  and  application  of  the  microscope. 
Among  other  novelties  of  decided  improvement  in  connection  with  it 
may  be  considered  the  Synonym  of  Histology,  or  the  doctrine  of  Tex- 
ture ;  which  seems  to  mark  its  boundaries  and  intentions  with  a  defini- 
tiveness,  palliating  largely,  if  not  justifying,  its  substitution  for  the  origi- 
nal phrase  itself  of  General  Anatomy ;  though  now  sanctioned  by  half 
a  century  nearly  of  use,  and,  almost  consecrated  by  the  choice  of 
Bichat  himself. 

If  the  Anatomy  of  the  period  alluded  to  had  a  decided  impulse 
beyond  that  of  the  preceding  century,  so  the  Anatomy  of  the  present 
period  may  justly  claim  a  well-marked  and  triumphant  advance  beyond 
that  of  1826 :  organs  before  unknown,  now  discovered — arrangements 
of  parts  formerly  in  obscurity,  now  detected — textures  not  long  ago  of 
an  uncertain  and  disputable  character,  now  elucidated  and  settled. 
The  anatomy  of  the  most  important  membranes,  as  the  Mucous,  formerly 
passed  over  as  if  there  were  scarcely  any  descriptive  features  whatever 
in  them,  now  furnished  with  a  detail — extension — and  minuteness  of 
observation,  leaving  the  impression,  nearly,  that  there  is  nothing  more 
to  be  learned  about  them.  Those  untractable  and  mineral-like  bodies, 
the  teeth,  exciting  once  almost  the  doubt  of  intrinsic  organization,  now 
penetrated  by  the  microscope  in  a  wonderful  manner,  and  exhibiting 
the  most  surprising  organization :  an  organization  so  characteristic  and 
permanent  that  it  has  become  one  of  the  most  efficient  means  of  dis- 
criminating, in  fragments  of  animals,  the  kind  to  which  they  belonged, 
whether  of  the  present  or  of  a  former  order  of  the  world.  Each  of 
the  component  parts  of  the  teeth,  the  cement,  enamel,  and  ivory,  being 
found  to  exhibit  a  specific  organization  ;  its  fibrils  or  its  tubules ;  whose 
arrangement,  in  being  specific,  gives  decided  character  to  the  specimen 
in  question. 


PREFACE  TO  THE  SEVENTH  EDITION.  Vll 

Bichat  labored  but  little  with  the  microscope,  too  imperfect  an  in- 
strument at  the  period  of  his  life,  and  too  discrepant  in  its  indications ; 
his  slender  use  of  it  may  be  considered  as  marking  a  profound  distrust 
in  it ;  otherwise,  with  his  talents  and  energy,  much  more  of  the  ground 
of  modern  anatomy  would  have  been  covered  by  him.  He  depended 
principally  upon  maceration,  chemical  appliances,  and  pathological 
changes.  But  it  is  now  a  new  instrument,  in  virtue  of  its  freedom 

o  ' 

from  the  imperfections  of  a  former  period,  and  we  may  here  with  pro- 
priety occupy  some  space  in  an  exposition  of  its  merits.  Invented  first 
by  the  Dutch  or  Italians,  its  improvements  have  been  slow,  both  in  the 
mechanical  and  in  the  optical  part.  The  latter  has  of  course  been 
forced  to  await  the  precession  of  new  discoveries  in  the  laws  of  Light, 
and  as  they  have  been  ascertained  and  developed,  the  results  have 
been  applied  to  the  construction  of  the  Microscope.  This  instrument 
was  not,  however,  destitute  of  interest  as  far  back  as  nearly  two  cen- 
turies ago ;  for  it  was  in  1674  that  by  it  Hartsoeker  discovered  the 
existence  of  animalcules  in  the  spermatic  liquor  of  male  animals. 

The  earlier  observers  generally  used  single  glasses  of  a  lenticular 
shape ;  but  in  a  short  time  followed  the  invention  of  the  compound 
microscope,  where  the  image  formed  by  the  glass  nearest  the  object 
became  itself  the  subject  of  a  farther  magnifying  power.  For  a  long 
period,  however,  the  imperfections  of  both  kinds  of  instruments  were 
such  as  to  present  the  most  serious  obstacles  to  correct  observations, 
so  that  every  new  eye  seemed  to  give  a  new  cast  to  microscopical  con- 
clusions. One  imperfection  came  from  the  pencils  of  light,  passing 
confusedly  through  a  curved  surface  of  glass,  and  constituted  spherical 
aberration :  another  imperfection  arose  from  the  different  coloured  rays 
of  light  being  transmitted  through  different  angles  of  refrangibility, 
and  constituted  chromatic  aberration.  These  difficulties  were  to  a  large 
degree  at  length  surmounted  in  1829,  by  the  invention  of  Wollaston's 
doublet;  since  wrhich,  improvements  have  been  incessantly  occurring 
both  in  the  optical  and  mechanical  parts  of  the  microscope,  in  regard 
to  accuracy,  power,  and  applicability. 

To  appreciate  the  power  of  the  compound  microscope  of  the  present 
period,  we  are  to  remember  that  the  human  eye  in  good  order,  but  un- 
assisted, sees  with  difficulty  an  object  whose  diameter  is  the  hundredth 
part  of  a  line,  say  the  twelve-hundredth  part  of  an  inch;  but  the  powers 
of  the  microscope  are  now  so  adjusted  that  the  diameter  of  such  an 
object  may  be  multiplied  or  amplified  one,  two,  or  more  thousands  of 
times;  thus  making  what  was  previously  imperceptible,  a  broad,  well- 
lighted,  and  well-defined  disk  or  plane.  The  consequence  of  this  suc- 
cessful construction  is  that  a  surface  not  more  than  a  millionth  of  an 
inch  across  may  be  satisfactorily  examined.  We  may  hence  infer  the 


Vlll  PREFACE  TO  THE  SEVENTH  EDITION. 

applicability  of  the  compound  microscope  in  ascertaining  the  healthy 
and  the  diseased  condition  of  the  filaments  and  molecules  of  the  human 
body;  the  state  of  its  excretions  and  secretions;  the  condition  of  its 
fluids ;  and  the  manner  of  germinal  evolution. 

Of  all  the  fluids  of  the  body,  the  blood  is  admitted  to  be  the  most 
interesting  from  its  quantity,  and  from  its  relation  to  all  the  great 
functions  of  life.  Containing,  as  it  does,  the  source  as  well  as  the  issues 
of  life,  every  one  regards  it  as  no  common  fluid.  At  an  early  period, 
therefore,  the  microscope  was  applied  to  it,  and  detected,  by  the  eyes  of 
Malpighi,  numerous  rounded  granules  called  blood-corpuscles.  It  was 
for  one  hundred  and  sixty  years  debated  whether  these  corpuscles  were 
spherical  or  flat,  and  for  a  long  time,  whether  they  were  solid  or  perfo- 
rated; also,  their  exact  size,  and  the  relation  of  the  coloring  matter 
to  them.  In  place  of  all  this  uncertainty  the  facts  now  admitted  are, 
that  they  are  minute,  disk-like  cells,  containing  round  or  oval  nuclei, 
and  having  incorporated  with  them  the  material  which  gives  redness  to 
the  blood  of  many  animals,  though  this  color  does  not  exist  in  all. 
Their  nucleated  state  is  not  so  uniform  in  man  as  in  some  other  animals, 
and  is  supposed  to  be  limited  to  certain  stages  of  their  development 
when  it  subsequently  disappears.  These  blood-corpuscles  are  circular 
in  man,  and  in  all  the  mammalia,  except  the  camel  tribe,  in  which  they 
are  elliptical ;  all  other  vertebrated  animals,  including  reptiles,  birds, 
and  fishes,  have  them  elliptical.  In  man  the  diameter  of  these  globules 
averages  about  the  ^^th  part  of  an  inch,  or  g^-gd  of  a  line,  some 
being  ^^^th  and  others  ^^^th  of  an  inch;  but  in  the  proteus,  where 
they  are  elliptical,  their  length  is  as  much  as  ^th  of  a  line,  or  the 
slflth  of  an  inch.  In  the  Napu  musk  deer  their  diameter  descends  to 
the  jzfc o^th  part  of  an  inch.  Omnivorous  animals  have  them  larger 
than  carnivorous,  and  these  again  larger  than  herbivorous.  There  is 
no  absolute  proportion  between  their  size  and  that  of  the  animal  to 
which  they  belong.  Thus,  in  the  elephant  their  diameter  is  only  twice 
that  of  man. 

The  microscope  has  also  distinguished  in  the  chyle  or  elaborated  part 
of  our  food,  numerous  appropriate  globules  of  variable  size,  larger  or 
smaller  than  these  of  the  blood.  These  corpuscles,  when  perfect,  con- 
sist of  granules  assembled  around  a  central  one.  Bodies  of  this  kind 
are  found  in  the  lacteals  of  the  mesentery ;  and  bodies  nearly  analo- 
gous, called  lymph-globules,  are  found  in  the  lymphatic  vessels,  in  dif- 
ferent parts  of  the  system. 

It  is  well  known  that  human  fat  is  in  large  part  fluid,  and  such  being 
the  case,  the  inquiry  very  naturally  arose  why  does  not  this  fluid  then 
gravitate  to  the  legs  and  feet,  like  water  in  dropsy?  A  reply  of  pro- 
blematical truth  was  given,  that  this  oil  was  contained  in  oil  or  fat  cells 


PREFACE  TO  THE  SEVENTH  EDITION.  ix 

like  those  of  the  juice  of  an  orange;  but  the  parts  were  too  fine  for 
positive  proof.  The  latter  we  have  now  got  indisputably  from  the 
microscope;  the  answer  first  came  from  Malpighi,  but  it  required  near 
two  centuries  of  observations  to  verify  it. 

The  cuticle,  that  important  covering  of  the  body,  without  which  the 
finest  satin  would  feel  harsh  and  excite  pain;  and  also  without  which 
no  internal  supply  of  fluids  could  make  up  the  rapid  loss  from  the  sur- 
face by  evaporation — the  cuticle,  I  say,  has  its  structure  presented  to 
us  in  a  most  interesting  light  under  the  new  powers  of  the  compound 
microscope.  It  is  first  of  all  a  remarkable  point  in  minute  anatomy 
that,  wherever  there  is  a  free  surface,  almost  without  exception  the  sur- 
face in  question  is  provided  with  a  cuticle,  or  an  analogous  structure, 
as  the  epithelium,  and  which  consists  of  one  or  more  layers  of  primary 
cells.  We  hence  detect  this  covering  on  the  entire  surface  of  the  skin  ; 
of  the  alimentary  canal ;  of  the  genito-urinary  cavities ;  upon  the  secre- 
tory ducts ;  upon  the  free  surface  of  the  peritoneum,  pleura,  pericardium, 
arthrodial  membranes,  synovial  sacs,  in  the  cavities  of  the  blood-vessels, 
&c.  &c. 

These  cuticles  or  epithelia  are  all  formed  of  scales,  which  are  found 
to  be  cells  in  a  state  of  compression,  and  having  a  nucleus.  A  pressed 
lime  or  lemon  will  give  some  idea  of  the  mere  mechanism  alluded  to. 
The  minuteness  of  microscopical  observation  may  be  understood  when 
it  is  stated  that  the  nuclei  of  such  cells  have  been  ascertained  to 
measure  about  the  g.oVi^h  °f  an  incn>  an(l  that  within  them  there  are 
nucleoli  estimated  at  the  diameter  of  the  g^^th  of  an  inch. 

Some  of  the  scales  or  cells  are  rounded  or  polygonal,  others  are 
cylindrical  or  conoidal,  and  others  again  are  terminated  at  their  free 
extremities,  by  a  very  fine  down  or  line  of  fringe  called  cilia,  whose 
length  is  from  y^o^h  to  T2,I^TJtn  °f  an  incn:  some  observers  claim  to 
have  seen  them  as  short  as  about  the  ^J^k  °f  an  inch.  These  cilia 
have  during  life,  and  even  for  some  time  after  death,  an  incessant  motion, 
sweeping  backwards  and  forwards,  and  whirling  around  at  their  free 
extremities  so  as  to  describe  the  figure  of  a  cone. 

The  Cellular  form  is  the  universal  primary  condition  of  all  vegetable 
and  animal  matter.  It  lays  the  foundation  of  everything,  and  its 
traces  and  modifications  may  be  found  in  every  tissue,  at  every  stage 
of  life,  from  the  earliest  rudimentary  to  the  most  perfect  condition.  To 
Schwann  we  owe  this  idea,  more  prolific  in  consequences  and  in  philo- 
sophical inductions  than  any  other  in  the  category  of  physiology.  It 
has  been  applied  by  Dr.  Barry  to  the  tracing  of  the  Embryo  from 
the  Germinal  vesicle  of  Purkinje',  to  the  evolution  of  all  the  organs  of 
the  body.  In  every  instance  it  would  seem,  from  the  researches  of 
Schwann,  Valentin,  and  others,  that  organism  is  first  seen  as  a  single 


X  PREFACE  TO  THE  SEVENTH  EDITION. 

cell  ;  this  cell  within  its  enclosure  gives  birth  to  others  ;  and  from  them, 
in  their  turn,  germinate  others  ;  and  so  the  process  goes  on  in  an 
endless  succession  till  life  terminates. 

Nutrition  itself  appears  to  consist  in  an  evolution  of  new  cells  from 
pre-existing  old  ones,  which,  becoming  effete,  are  broken  down  and  car- 
ried off.  While  the  cells  are  in  a  state  of  active  vitality,  each  set 
derives  from  the  blood  the  organic  compounds  most  suitable  to  their 
nature;  as  the  structure  of  every  separate  portion  of  the  body  has 
a  special  affinity  for  some  of  the  particular  constituents  of  the  blood, 
and  not  for  others.  The  appropriation  of  these  constituents  constitutes 
assimilation,  but  the  regulating  power  which  directs  this  appropriation 
is  one  of  the  secrets  of  vitality,  the  nature  of  which  we  are  as  little 
likely  to  know  as  that  of  gravitation  or  cohesion  in  the  phenomena  of 
physics. 

It  is  a  remarkable  trait  in  animal  organism  that  a  form  of  growth 
unknown  to  it  in  the  healthy  state,  in  fact  parasitic,  takes  possession 
of  certain  parts,  and,  by  its  evolutions,  destroys  the  matrix  upon  which 
it  feeds.  Thus,  in  the  terrifying  and  fatal  form  of  disease  called  Can- 
cer, which  is  so  apt  to  assail  the  glandular  textures  of  the  human  body, 
it  has  been  shown  by  Miiller  and  others,  that  it  consists  in  the  growth 
of  a  mass  of  cells,  which  develop  themselves  in  their  successive  gene- 
rations with  extreme  rapidity  ;  and  destroy  the  surrounding  tissues 
both  by  pressure  and  by  abstracting  the  blood  essential  to  their  nutri- 
tion. These  parasitic  agglomerations  have  an  independent  power  of 
growth  and  of  reproduction,  and  can  be  propagated  into  healthy  ani- 
mals by  inoculation.  It  is  even  said  that  vegetable  organisms  have 
been  latterly  traced  in  the  parasitic  state  upon  the  body  of  animals  ; 
so  that  a  true  plant  has  been  found  having  a  regular  apparatus  of 
nutrition  arid  of  reproduction.1  We  have  it  announced  too  by  MM. 
Andral  and  Gavarret,  that  in  all  albuminous  fluids,  a  trivial  chemical 
appliance  of  a  certain  kind  will  develop  an  infusory  vegetable,  to  be 
found  with  the  aid  of  the  microscope.2 

Color,  it  is  now  ascertained,  depends  upon  the  existence  of  a  parti- 
cular class  of  vesicles,  called  Pigment  Cells.  From  them  are  derived 
the  black  pigment  of  the  eye,  and  that  which  marks  the  distinction 
of  races  in  the  human  family.  In  these,  as  in  other  instances,  the  pig- 
ment is  composed  of  minute  dark  granules  deposited  in  primary  cells. 
These  granules  are  among  the  most  minute  formations  of  the  body, 
and  in  their  longest  diameter  measure  only  %-Q>VVO^  °f  an  inch. 


1  Carpenter,  Human  Physiology,  first  Am.  ed.,  p.  404.  Numerous  observations  on  the  para- 
sitic plants  of  animals,  and  especially  of  insects,  have  been  made  within  the  last  two  years 
by  Dr.  Leidy.     See  Proceedings  of  the  Acad.  Nat.  Sciences,  Phila.,  1850  and  1851. 

2  Bulletin  of  Med.  Science,  by  J.  Bell,  M.  D.  Sept.  .2-13,  from  Gazette  Medicale. 


PREFACE  TO  THE  SEVENTH  EDITION.  XI 

The  nails  of  the  fingers  and  toes,  simple  and  inorganized  as  they 
seem  to  be,  are  yet  found  by  the  same  searching  process  to  be  formed 
from  an  aggregation  and  successive  growth  of  cells. 

Muscular  tissue  has  also  received  a  copious  elucidation  from  this 
source  of  observation.  A  point  is  now  definitively  settled,  that  the 
muscular  fibres  of  the  stomach,  bowels,  and  other  interior  organs  are 
very  different  in  their  anatomy  from  the  muscular  fibres  of  the  limbs, 
and  such  generally  as  are  engaged  in  the  larger  motions  of  the  body. 
The  nerves,  formerly  considered  as  mere  strings,  are  now  ascertained  to 
be  tubes.  These  tubes  are  collected  into  fasciculi  making  a  chord  of 
some  magnitude.  To  superficial  observation,  these  tubes  or  ultimate 
fibres  seem  to  coalesce  by  reciprocal  anastomosis ;  but  it  is  now  settled 
by  the  microscope,  that  from  the  brain  and  spinal  marrow  to  the  peri- 
pheral or  outer  termination  of  these  tubes,  they  keep  perfectly  and 
exactly  distinct  from  each  other.  But  as  each  nervous  fibril  has  its 
distinct  origin  at  one  point  of  the  brain,  and  its  distinct  termination  at 
the  other  end  upon  a  muscle  or  a  sentient  surface,  the  action  of  the 
muscles  and  the  perceptions  are  better  regulated  and  more  precise 
than  they  would  be  under  a  different  arrangement. 

With  such  augmented  means  of  anatomical  research,  the  progress  of 
the  science  has  been  immense.  Contributions  of  the  most  valuable 
kind  have  been  made  in  the  British  dominions,  in  Germany,  France, 
Switzerland,  and  elsewhere.  Modes  of  elucidation  by  plates,  drawings, 
models,  and  injections  have  been  improved.  Cabinets  of  great  value 
have  been  collected  and  arranged,  in  every  direction.  Our  own  coun- 
try has  felt  this  salutary  impulse,  by  advancing  in  its  scientific  labors 
and  books,  increasing  its  medical  schools,  multiplying  highly  instructed 
teachers  of  anatomy,  and  imparting  a  more  finished  degree  of  accom- 
plishment to  its  medical  graduates. 

Under  the  circumstances  actually  existing,  therefore,  in  the  civilized 
world,  there  has  never  been  a  period  more  propitious  to  the  cultivation 
of  Anatomy;  and  to  the  acquiring  of  points  of  knowledge  indispensable 
to  the  scientific  and  successful  treatment  of  disease.  And  it  is  in  this  view 
of  being  useful,  that  the  Author  once  more  submits  his  labors  to  the 
profession. 

PHILADELPHIA,  October  1846. 


PREFACE  TO  THE  EIGHTH  EDITION. 


A  CONTINUOUS  demand  for  the  Treatise  on  Special  Anatomy  and 
Histology  having  made  the  present  edition  expedient,  the  author  has 
endeavored  to  introduce  such  improvements  into  it  as  the  advancing 
condition  of  anatomy  seemed  to  require.  This  edition  is  distinguished 
from  the  preceding  ones  by  very  copious  illustrations,  amounting  in  all 
to  more  than  three  hundred.  Many  of  these  illustrations  are  taken 
directly  from  nature,  they  being  intended  to  explain  the  author's  pecu- 
liar views  on  points  of  anatomical  structure,  which  his  own  personal 
experience  led  him  to  infer  was  correct.  Others  are  from  the  Ana- 
tomical Atlas  of  Dr.  H.  H.  Smith,  which  was  used  as  a  special  refer- 
ence in  the  seventh  edition  of  this  work.  While  the  remainder  are 
from  various  sources,  embraced  in  the  large  collection  of  Anatomical 
Engravings  in  the  hands  of  the  publishers. 

An  index  to  the  figures  will  be  found  at  the  beginning  of  the  work; 
and  though,  from  accidental  causes,  the  original  source  of  them  cannot 
be  traced  in  every  instance,  yet  the  author  has  endeavored  to  steer 
clear  of  any  presumptive  claim  to  such,  by  stating  specially  such  as 
have  emanated  from  his  own  dissections  and  observations. 

As  the  composition  of  this  work  has  been  in  strict  reference  to  the 
course  of  study  pursued  in  the  University  of  Pennsylvania,  it  has  been 
kept  in  as  compendious  a  state  as  possible,  so  that  there  should  be  no 
unnecessary  loss  of  time  in  perusing  it.  That  it  will  meet  all  the 
requisitions  of  an  enlightened  and  well-exercised  judgment  in  others 
is  what  the  author  can  scarcely  expect ;  he  has,  however,  spared  no 
pains  to  make  it  as  useful  as  the  circumstances  admit,  and  with  that 
view  introduces  it  to  the  public  attention  in  its  new  form. 

PHILADELPHIA,  July,  1851. 


TABLE   OF   COiNTENTS. 


VOLUME    I. 

PAGE 

Preface, v 

Reference  to  Illustrations, xxiii 

Bibliography,  xxxi 

Introduction — Histology, 33 

Chemical  Composition, 48 

Histogeny, 63 

BOOK  I.— SKELETON. 

PART  I.— Skeleton, 73 

CHAP.  I. — Histology  of  the  Bones, 74 

Sect.  1.— Number  and  Texture  of  Bones, 74 

2. — Composition  of  Bones, 83 

CHAP.  II.— Sect.  1.— Periosteum,  90 

2.— Medulla, 92 

CHAP.  III.— Osteogeny, 94 

Sect.  1. — Development  of  Bones, 94 

2.— Growth  of  Bones, 98 

3.— Formation  of  Callus, 102 

PART  II.— Bones,  individually, 105 

CHAP.  L— Trunk, 106 

Sect.  1.— Spine, 106 

2.— Development  of  Vertebral  Column, 118 

3.— Uses  of  Vertebral  Column, 118 

4. — Ossa  Innominata, 123 

5.— Pelvis,  generally 128 

6. — Development  of  Pelvis, 130 

7. — Mechanism  of  Pelvis, 131 

8.— Thorax, 132 

9. — Cartilages  of  Ribs, 137 

10.— Development  of  Thorax, 138 

11.— Mechanism  of  Thorax, 140 

CHAP.  II.— Head, 143 

Sect.  1.— Cranium, 143 

2. — Individual  Bones  of  Cranium, 145 

3.— Face, 158 


XVI  TABLE  OF  CONTENTS. 

PAGE 

CHAP.  III. — General  Considerations  on  Head, 170 

Sect.  1. — Diploic  Structure  of  Cranium, 170 

2.— Sutures, .- 172 

3. — Internal  Surface  of  Cranium, 178 

4. — External  Surface  of  Head, 180 

5. — Nasal  Cavities, 184 

6.— Orbits  of  the  Eyes, 185 

7. — Facial  Angle  and  National  Peculiarities  of  Face, 187 

8. — Development  of  Foetal  Head, 193 

CHAP.  IV.— Os  Hyoides, 196 

V.— Upper  Extremities, 197 

Sect.  1.— Shoulder, 197 

2.— Arm, 201 

3.— Fore  Arm, 203 

4.— Hand, 207 

5. — Development  of  Upper  Extremities, ,215 

6. — Mechanism  of  Upper  Extremities, 216 

7.— Motions  of  Shoulder, 217 

8.— Motions  of  Shoulder  Joint, 218 

9.— Motions  of  Fore  Arm, 219 

10.— Motions  of  Hand, 221 

CHAP.  VI.— Inferior  Extremities, 223 

Sect.  1.— Thigh  Bone, 223 

2.— Leg, 227 

3.— Foot, 233 

4. — Development  of  Inferior  Extremities, 241 

5.— Standing, 242 

6. — Locomotion, 247 

.PART  III. — Cartilaginous,  Fibrous,  Fibro-cart.,  and  Synovial  Tissues, 253 

CHAP.  I. — Cartilaginous  System, 253 

Sect.  1. — Preternatural  Development  of  Cartilages, 257 

2.— Perichondrium, 257 

CHAP.  II. — Ligamentous  or  Desmoid  Tissue, .'....258 

III. — Histology,  Ligamento-Cartilaginous  System, 262 

IV.— Articulations, 263 

Sect.  1.— Mechanism  of  Joints, 263 

2. — Articular  Cartilages, 263 

3. — Synovial  Articular  Cartilages, 265 

CHAP.  V. — Individual  Articulations, 267 

Sect.  1. — Articulation  of  Lower  Jaw, 267 

CHAP.  VI. — Ligaments  of  Spine 270 

VII.— Ligaments  of  Pelvis, 279 

VIII.— Articulations  of  Thorax, 282 

IX. — Articulations  of  Upper  Extremities, 286 

X. — Articulations  of  Lower  Extremities, 300 

BOOK  n.-— INTEGUMENTS  OF  THE  BODY. 

PART  I.— Histology  of  Cellular  and  of  Adipose  Substance, 315 

CHAP.  I.— Cellular  Substance, ..  315 


TABLE  OF  CONTENTS.  XV11 

PAGE 

CHAP.  II.— Adeps, 323 

PART  II.— Dermoid  Covering, 327 

CHAP.  I.— The  Skin, 327 

Sect.  1.— Cutis  Vera, 328 

2.— Rete  Mucosum, 331 

3.__Cuticle, 335 

CIIAP.  II.— Secretory  Organs  of  Skin, 338 

III.— Nails, 345 

IV.— Hairs, 347 

BOOK  III.— MUSCLES. 

PART  I.— Muscles  and  Tendons  in  general, 353 

CHAP.  I. — Histology  of  Muscles, 353 

Sect.  1.— Muscles  of  Animal  Life, 355 

2.— Muscles  of  Organic  Life, 362 

CHAP.  II. — Muscular  Motion, 363 

III. — Shape  of  Voluntary  Muscles, 367 

IV.— Tendons, 368 

PART  II.— Special  Anatomy  of  Muscles, 370 

CHAP.  I.— Muscles  of  Head  and  Neck, 370 

Sect.  1.— Muscles  of  Face, 370 

2.— Muscles  of  Neck, 376 

CHAP.  II. — Muscles  of  Trunk, 384 

Sect.  1.— Muscles  on  Front  of  Thorax, 384 

2. — Muscles  and  Fasciae  of  Abdomen, 386 

3. — Muscles  of  Upper  and  Posterior  Parietes  of  Abdomen, 396 

4. — Muscles  on  Posterior  Face  of  Trunk, 401 

CHAP.  III. — Of  the  Fasciae  and  Muscles  of  the  Upper  Extremities, 410 

Sect.  1.— Fascise 410 

2.— Muscles  of  Shoulder, 413 

3. — Muscles  of  Arm, 415 

4. — Muscles  of  Fore  Arm,  418 

5.— Muscles  of  Hand, 427 

CHAP.  IV. — Of  the  Fasciae  and  Muscles  of  the  Lower  Extremities, 432 

Sect.  1.— Fasciae, 432 

2._Muscles  of  Thigh, 437 

3.— Muscles  of  Leg, '. 446 

4.— Muscles  of  Foot, 452 

BOOK  IV. 

ORGANS  OF  DIGESTION, 457 

PART  I.— Organs  of  Mastication  and  Deglutition, 458 

CHAP.  I.— Mouth, 458 

II.— Teeth, 460 

Sect.  1.— Number  of  Teeth,  and  Subdivision, 460 

2.— Texture  and  Organization  of  the  Teeth, 463 

3.— Gums, 470 

4.— Evolution  of  Teeth, 470 

VOL.  I. — 2 


XV111  TABLE  OF  CONTENTS. 

PAGE 

Sect.  5.— Dentition, 476 

6. — Irregularities  in  Dentition, 481 

CHAP.  III.— Tongue, 483 

Sect.  1.— Muscles  of  Tongue, 484 

2. — Mucous  Covering  of  Tongue, 486 

CHAP.  IV.— Palate, 489 

V. — Glands  of  Mouth, 492 

Sect.  1. — Muciparous  Glands, 492 

2.— Salivary  Glands, 493 

CHAP.  VI. — Pharynx  and  (Esophagus, 496 

Sect.  1.— Pharynx, - 496 

2.— (Esophagus, 500 


TABLE   OF   CONTENTS. 


VOLUME    II. 


BOOK  IV. 

CONTINUED. 

PAGE 

PART  II.— Glands  and  Organs  of  Assimilation, 5 

CHAP.  I. — Prolegomena  on  Structure  of  Glands, 5 

II. — Abdomen,  generally, 12 

III. — Of  the  Peritoneum  and  Serous  Membranes,  generally, 17 

Sect.  1. — Peritoneum, 17 

2.— Omenta, 20 

3. — Histology  of  Serous  Membranes, 23 

CHAP.  IV. — Chylopoietic  Viscera, 28 

Sect.  1.— Stomach, 28 

2.— Intestinal  Canal, 33 

3. — Minute  Anatomy  of  the  Mucous  Coat  of  the  Alimentary  Canal,  48 

4. — Histology  of  Mucous  Membranes, 56 

CHAP.  V. — Assistant  Chylopoietic  Viscera, 61 

Sect.  1.— Liver, 61 

2.— Spleen, .' 74 

3. — Pancreas, 78 

BOOK  Y. 
URIXART  ORGANS, 81 

BOOK  VI. 

ORGANS  OF  GENERATION, 97 

CHAP.  I.— Organs  of  Generation  in  Male, 97 

Sect.  1.— Testicles, 97 

2. — Urethral  Glands  and  Apparatus, 104 

3.— Penis, 106 

4. — Muscles  and  Fasciae  of  Perineum, 113 

CHAP.  II. — Organs  of  Generation  in  Female, 118 

Sect.  1.— Vulva, 118 


XX  TABLE  OP  CONTENTS. 

PAGE 

Sect.  2.— Vagina, 121 

3. — Uterus  and  its  Appendages, 123 

CHAP.  III. — Lactiferous  Glands, 131 

BOOK  VII. 

ORGANS  OP  RESPIRATION, 137 

CHAP.  I. — Larynx, 137 

II. — Trachea  and  Glands  bordering  upon  it, 147 

Sect.  1. — Trachea  and  Bronchia, 147 

2.— Thyroid  Gland, 151 

3.— Thymus  Gland, 153 

CHAP.  III.— Lungs, 154 

BOOK  VIII. 

CIRCULATORY  SYSTEM, 106 

PART  I.— Histology  of  Circulatory  System, 166 

CHAP.  I. — General  Considerations, 166 

II.— Arteries,  Texture  of, 176 

III.— Veins,  Texture  of, 181 

IV.— Blood, 185 

Sect.  1.— Serum, 187 

2.— Fibrine, 188 

3.— White  Corpuscles, 190 

4.— Red  Corpuscles, 190 

PART  II.— Special  Anatomy  of  Circulatory  System, 194 

CHAP.  I. — Heart  and  Pericardium, 194 

II.— Arteries, 204 

Sect.  1. — Aorta  and  the  Branches  from  its  curvature, 204 

2. — Carotids  and  their  Branches, 207 

3. — Subclavian  and  its  Branches, 215 

4. — Branches  of  Descending  Thoracic  Aorta, 226 

5. — Branches  of  Abdominal  Aorta, 228 

6.— Primitive  Iliac  Arteries, 234 

7. — Internal  Iliac  Arteries, 234 

8. — External  Iliac  Arteries, 239 

CHAP.  III.— Veins, 251 

Sect.  1.— Veins  of  Head  and  Neck, 252 

2. — Veins  of  Upper  Extremities, 259 

3.— Veins  of  Lower  Extremities, 262 

4. — Veins  of  Abdomen, 265 

5._Vena  Portarum, 269 

CHAP.  IV. — Peculiarities  in  the  Circulatory  System  of  the  Foetus, 271 

Sect.  1.— Peculiarities  of  Foetus,  &c., 271 

2. — Peculiarities  of  Circulation  of  Foetus,  &c., 275 

CHAP.  V.— Histology  of  Absorbent  System, 280 

VI. — Special  Anatomy  of  Absorbent  System, 287 

Sect.  1.— Absorbents  of  Head  and  Neck, 287 

2.— Absorbents  of  Upper  Extremities, 289 

3.— Absorbents  of  Inferior  Extremities, ..  ...  290 


TABLE  OF  CONTENTS.  XXI 

PAGE 

Sect.  4.— Deep  Absorbents  of  Pelvis, 293 

5.— Absorbents  of  Organs  of  Digestion 295 

6.— Absorbents  of  Viscera  of  Thorax, 300 

7. — Absorbents  of  Parietes  of  Trunk, 301 

8.— Thoracic  Ducts, 303 

BOOK  IX. 

NERVOUS  SYSTEM, 306 

PART  I.— Histology  of  the  Nervous  System, 306 

II. — Special  Anatomy  of  the  Central  Portion  of  the  Nervous  System, ...  321 

CHAP.  I. — Medulla  Spinalis  and  its  Membranes, 321 

Sect.  1. — Membranes  of  Spinal  Marrow, 321 

2.— Medulla  Spinalis, .'. 323 

3.— Blood-Vessels  of  Medulla  Spinalis, 331 

CHAP.  II.— Encephalon, 332 

Sect.  1. — Membranes  of  Brain, 332 

2.— Medulla  Oblongata, 340 

3. — Protuberantia  Annularis, 344 

4. — Cerebellum, 345 

5.— Cerebrum,  348 

6. — Nerves  of  Encephalon, 364 

7. — Arteries  of  Encephalon, 372 

PART  III.— Senses, 376 

CHAP.  I.— Nose, 376 

II.— Eye, 385 

Sect.  1. — Auxiliary  parts  of  Eye, 385 

2.— Ball  of  the  Eye, 399 

CHAP.  III.— Ear, 419 

Sect.  1.— External  Ear, 419 

2. — Tympanum, 423 

3. — Labyrinth, '. 428 

4.— Nerves, 433 

PART  IV.— Special  Anatomy  of  Nerves, 435 

CHAP.  I. — Nerves  of  Encephalon,  435 

Sect.  1.— Nervus  Olfactorius, 435 

2.— Nervus  Opticus, 435 

3.— Nervus  Motor  Oculi, 435 

4. — Nervus  Trochlearis, 437 

5. — Nervus  Motor  Externus, 438 

6. — Nervus  Trigeminus, 438 

7. — Nervus  Facialis, 447 

8. — Nervus  Hypoglossus, 4^9 

9. — Nervus  Accessorius, 451 

10. — Nervus  Glosso-Pharyngeus, 452 

11. — Nervus  Pneumogastricus, 453 

CHAP.  II. — Sympathetic  Nerve, 458 

III.— Nerves  of  Medulla  Spinalis, 469 

Sect.  1. — Upper  Nine  Spinal  Nerves, 469 

2. — Thoracic  Spinal  Nerves, 479 

3. — Abdominal  Spinal  Nerves, 481 


ILLUSTRATIONS  VOL.  I. 


FRONTISPIECE.    Cranial  Vertebrae  from  Sus  Scrofa,     Homer,  Nature. 


FIG.      PAGE 

1.  63.  Primary  Organic  Cell, 

2.  65.  Primary  Cells,  Development  of, 


Epidermis,  Development  of, 
Cell  Development, 
Ciliated  Epithelial  Scales, 

Cell  Development — Yeast  Plant, 

Young  Os  Femoris, 

Bone,  Texture  of, 

Bone,  Filaments  of, 

Bone,  Compact  and  Cellular  Structure, 

Bone,  Lamellas  of, 

Haversian  Canals, 

Haversian  Ossicle  and  Corpuscles  of  Pur- 

kinje". 

Corpuscles  of  Purkinjes, 
Lepidosteus,  Scale  of, 
External  Periosteum, 
Punctum  Ossificationis, 
Calcification,  Progress  of,  in  Young  Os 

Humeri, 

Calcification  in  Osteophyte, 
Spinal  Column, 
Vertebra,  Cervical, 
Vertebrae,  Cervical, 
Vertebrae,  Dorsal, 
Vertebrae,  Lumbar, 
Sacrum, 
Os  Coccygis, 
Os  Innominatum, 
Os  Innominatum, 
Pelvis,  Female, 
Thorax,  Bones  of, 
First  Rib, 
Sternum, 


3. 

67. 

4. 

67. 

5. 

70. 

6. 

71. 

7. 

75. 

8. 

75. 

9. 

76. 

10. 

77. 

11. 

78. 

12. 

78. 

13. 

80. 

14. 

82. 

15. 

82. 

16. 

91. 

17. 

97. 

18. 

98. 

19. 

100. 

20. 

107. 

21. 

109. 

22. 

111. 

23. 

112. 

24. 

114. 

25. 

115. 

26. 

117. 

27. 

124. 

28. 

125. 

29. 

130. 

30. 

133. 

31. 

135. 

32. 

136. 

Todd  &  Bowman. 
Schleiden,  see  Quain  &  Shar- 

Pe7- 
Mandl. 

Barry,  see  Quain  &  Sharpey. 
Sharpey,    &c.,    see   Todd  & 

Bowman. 

Meyen,  see  Quain  &  Sharpey. 
Wistar  Museum,  see  Atlas. 
Wistar  Museum,  see  Atlas. 
Homer,  Nature. 
Atlas,  see  Bougery  &  Jacob. 
Wistar  Museum,  see  Atlas. 
Todd  and  Bowman. 


Mandl. 

Carpenter,  see  Physiology. 
Wistar  Museum,  see  Atlas. 
Atlas,  see  Bougery  &  Jacob. 

Quain  and  Sharpey. 

Leidy,  Nature. 

Atlas,  see  Bougery,  &c. 

Wilson. 

Atlas,  Nature. 


Wilson. 
« 

Meigs's  Midwifery. 

Wilson. 

Atlas,  from  Nature. 


XXIV 


ILLUSTRATIONS   TO  VOL.  I. 


FIG. 

PAGE 

33. 

146. 

34. 

150. 

35. 

152. 

36. 

153. 

37. 

157. 

38. 

159. 

39. 

161. 

40. 

162. 

41. 

163. 

42. 

164. 

43. 

165. 

44. 

166. 

45. 

167. 

46. 

168. 

47. 

171. 

48. 

172. 

49. 

173. 

50. 

178. 

51. 

181. 

52. 

189. 

53. 

194. 

54. 

196. 

55. 

198. 

56. 

201. 

57. 

202. 

58. 

205. 

59. 

206. 

60. 

208. 

61. 

211. 

62. 

212. 

63. 

224. 

64. 

226. 

65. 

227. 

66. 

230. 

67. 

232. 

68. 

233. 

69. 

236. 

70. 

260. 

71. 

261. 

72. 

264. 

73. 

266. 

74. 

268. 

75. 

268. 

76. 

270. 

77. 

271. 

78. 

271. 

79. 

272. 

80. 

273. 

81. 

274. 

82. 

275. 

Os  Frontis, 

Os  Occipitis, 

Os  Temporis, 

Os  Sphenoidale, 

Os  Ethmoides, 

Maxillare  Superius, 

Intermaxillary  Bone, 

Palate  Bone, 

Os  Nasi, 

Os  Unguis, 

Os  Malae, 

Os  Spongiosum  Inferius, 

Vomer, 

Os  Maxillare  Inferius, 

Diploic  Sinuses  of  Cranium, 

Coronal  Suture, 

Lambdoidal  Suture, 

Internal  Base  of  Cranium. 

External  Base  of  Head, 

Facial  Angle, 

Fontanels, 

Os  Hyoides, 

Scapula, 

Clavicle, 

Os  Humeri, 

Ulna, 

Radius, 

Carpus, 

Carpus, 

Bones  of  Hand, 

Os  Femoris, 

Os  Femoris, 

Tibia, 

Fibula, 

Patella, 

Foot, 

Tarsus, 

White  Fibrous  Tissue, 

Yellow  Fibrous  Tissue, 

Articular  Cartilage, 

Articular  Cartilage, 

Articulation  Lower  Jaw, 

Articulation  Lower  Jaw, 

Ligaments  Lumbar  Vertebrae, 

Intervertebral  Plate, 

Intervertebral  Plate, 

Costal  Ligaments, 

Posterior  Vertebral  Ligament. 

Yellow  Ligaments, 

Articulation  Occiput  and  Atlas. 


Atlas,  from  Nature. 
«<  « 

Wilson, 
Atlas, 

Wilson,       " 
Atlas, 
Leidy, 
Atlas,          " 


Wilson. 
Breschet. 

Atlas,  see  Bougery,  &c. 
« 

Wilson. 
tf 

Wistar  Museum,  see  Atlas. 
Atlas,  from  Bougery,  &c. 
Wilson. 

Atlas,  from  Nature. 

Wilson. 

Atlas,  from  Nature. 


Wilson. 


Atlas,  from  Nature. 


Wilson. 

Atlas,  see  Bougery,  &c. 

Todd  &  Bowman. 

«  « 

Leidy,  from  Nature. 

Toynbee. 

Wilson. 


ILLUSTRATIONS   TO  VOL.  I. 


XXV 


PIG.  PAGE 

83.  276.  Articulation  Occiput  and  Atlas, 

84.  277.  Moderator  Ligaments, 

85.  279.  Pelvic  Ligaments, 

86.  284.  Anterior  Articulations  of  Ribs, 

87.  287.  Scapular  Articulations, 

88.  291.  Elbow  Joint, 

89.  291.  Elbow  Joint, 

90.  294.  Articulations  of  Hand, 

91.  296.  Synovial  Membrane  of  Wrist, 

92.  300.  Hip  Joint, 

93.  303.  Knee  Joint, 

94.  308.  Knee  Joint, 

95.  308.  Ankle  Joint, 

96.  308.  Ankle  Joint, 

97.  310.  Ligaments  Sole  of  Foot, 

98.  311.  Foot,  Articulations  of, 

99.  318.  Areolar  Tissue, 

100.  319.  Areolar  Tissue,  Development  of, 

101.  325.  Adipose  Tissue, 

102.  325.  Capillaries  of  Fat  Cells, 

103.  325.  Fat  Cells  of  Omentum, 

104.  329.  Nerves  of  Papillae  Tactus, 

105.  330.  Capillaries  of  Papillae  Tactus, 

106.  334.  Pigment  Cells, 

107.  336.  Epidermis, 

108.  336.  Epithelium  of  Tongue, 

109.  336.  Pigment  Molecules, 

110.  340.  Sudoriferous  Organs, 

111.  342.  Odoriferous  Glands, 

112.  345.  Thumb  Nail, 

113.  345.  Finger  Nail, 

114.  349.  Pulp  of  Hair, 

115.  349.  Whisker  of  Walrus, 

116.  354.  Muscular  Fibre, 

117.  355.  Elementary  Muscular  Fibre, 

118.  357.  Muscular  Fibrillse  of  Pig, 

119.  360.  Capillaries  of  Muscles, 

120.  361.  Nerves  of  Muscles, 

121.  362.  Muscular  Fibre,  Development  of, 

122.  371.  Muscles  of  Face  and  Neck, 

123.  382.  Muscles  of  Face  and  Neck, 

124.  389.  Muscles  of  Trunk  in  front, 

125.  390.  Muscles  of  Trunk,  side  view, 

126.  397.  Diaphragm,  &c., 

127.  402.  Muscles  of  Back, 

128.  411.  Brachial  Fascia, 

129.  415.  Muscles  on  Front  of  Arm, 

130.  418.  Muscles  on  Front  of  Fore  Arm, 


Wilson. 
« 

Atlas,  see  Bougery,  &c. 
Wilson. 


Atlas,  see  Bougery,  &c. 

Todd  and  Bowman. 

Leidy,  see  Quain  &  Sharpey. 

Berres. 
u 

Todd  and  Bowman. 
After  Gerber,  see  Atlas. 
Berres. 
Mandl. 


Gerber. 
Homer,  Nature. 

Atlas. 

« 

Hunter,  Catalogue,  &c. 
((  (t 

Quain  &  Sharpey. 
Todd   &    Bowman. 
Lealand,  see  Quain  and  Shar- 

pey. 

Berres. 

Burdach. 

Schwann,  see  Quain  &  Shar- 

pey. 

Atlas,  from  Bougery,  &c. 

Wilson. 
« 

Atlas,  from  Bougery,  &c. 


Wilson. 


XXVI 


ILLUSTRATIONS   TO  VOL.  I. 


FIG.  PAGE 

131.  420.  Tendons  of  Fingers, 

132.  423.  Muscles  on  Back  of  Fore  Arm, 

133.  428.  Muscles  of  Hand, 

134.  433.  Hernia,  Parts  Concerned  in, 

135.  437.  Muscles  of  Thigh,  front  view, 

136.  440.  Adductor  Muscles  of  Thigh, 

137.  443.  Muscles  on  Back  of  Thigh, 

138.  453.  Muscles  on  Back  of  Leg, 

139.  458.  Mouth, 

140.  459.  Nerves  of  Lip, 

141.  459.  Capillaries  of  Lip, 

142.  464.  Teeth, 

143.  464.  Enamel  Prisms, 

144.  465.  Dental  Tubules, 

145.  465.  Dental  Tubules, 

146.  467.  Dental  Tubules, 

147.  467.  Dental  Tubules, 

148.  470.  Dentition, 

149.  483.  Tongue, 

150.  485.  Musculus  Ovalis  Linguae, 

151.  488.  Papilla  Lingualis,  Capillaries  of. 

152.  489.  Epithelium  of  Cheek, 

153.  497.  Head  and  Throat,  Vertical  Section  of. 

154.  499.  Pharynx,  Muscles  of, 


Quain  &  Sharpey. 

Wilson. 
« 

Atlas,  from  Hern.  Corp.  Hu- 
man. &c. 
Wilson. 

Atlas,  from  Bougery,  &c. 

««  << 

Wilson. 

Atlas,  from  Bougery,  &c. 

Gerber. 

Berres. 

Nasmyth. 

Leidy,  see  Quain  &  Sharpey. 

After  Retzius,  Muller. 
<(  « 

Atlas. 
« 

Quain  and  Sharpey. 
Atlas,  from  Bougery,  &c. 
Homer,  Nature. 
Berres. 
Henle. 

Homer,  Nature. 


ILLUSTRATIONS  VOL.  II. 


FIG.  PAGE 

155.  8.  Diagram  of  Glandular  Structure, 

156.  13.  Regions  of  Abdomen, 

157.  15.  Abdominal  and  Thoracic  Viscera, 

158.  19.  Plan  of  Peritoneum, 

159.  28.  Stomach,  Outline  of, 

160.  30.  Peritoneum,  Pores  of,  on  Stomach, 

161.  32.  Stomach,  Mucous  Coat  of, 

162.  33.  Stomach,  Veins  of, 

163.  35.  Jejunum,  Valvulse  Conniventes, 

164.  36.  Intestinal  Villi,  Blood-vessels  of, 

165.  37.  Intestinal  Villi,  Absorbents  of, 

166.  41.  Large  Intestine, 

167.  43.  Ileo-colic  Valve, 

168.  44.  Ileo-colic  Valve, 

169.  46.  Rectal  Pouches, 

170.  48.  Colon,  Crypts  of, 

171.  49.  Epithelium  of  Intestine, 

172.  50.  Villi  and  Crypts  of  Ileum, 

173.  51.  Stomach,  Crypts  of,  and  Folds, 

174.  53.  Peyer's  Glands  from  Ileum, 

175.  59.  Ciliated  and  Nucleated  Cells  of  Mucous 

Surface, 

176.  59.  Ciliated  and  Nucleated  Cells,  Rounded 

Surface, 

177.  59.  Ciliated  Cylindrical    Cells,   Nucleated 

Surface, 

178.  59.  Cylindrical  Cells,  Grouped  Surface, 

179.  62.  Liver, 

180.  67.  Liver,  Acini  of,  with  Blood-vessels, 

181.  67,  Hepatic  Duct,  origin  of, 

182.  68.  Acinus  of  Liver, 

183.  70.  Cells  of  Liver, 

184.  70.  Pori  Biliarii, 

185.  70.  Biliary  Tube, 

186.  73.  Portal  Canal, 

187.  75.  Spleen, 

188.  79.  Pancreas  and  Spleen, 


Sharpey. 
Wilson. 

Atlas  from  Cloquet. 
><  « 

Sharpey. 

Horner,  from  Nature. 

Atlas  from  Cloquet. 

Horner,  from  Nature. 

Atlas  from  Cloquet. 

Lieberkiihn. 

Goodsir. 

Atlas  from  Cloquet. 


Wistar  Museum,  Atlas. 
«  «  «< 

Henl6. 

Wistar  Museum,  Atlas. 


Henle. 


Atlas,  Quain,  &c, 
Kiernan. 

«  ) 

Wistar  Museum,  Leidy. 

Bowman. 

Wistar  Museum,  Leidy. 

Leidy. 

Kiernan. 

Atlas,  see  Cloquet. 


XXV111 


ILLUSTRATIONS   TO  VOL.  II. 


FIG. 

PAGE 

189. 

83. 

190. 

85. 

191. 

87. 

192. 

88. 

193. 

91. 

194. 

93. 

195. 

96. 

196. 

101. 

197. 

105. 

198. 

107. 

199. 

109. 

200. 

110. 

201. 

113. 

202. 

122. 

203. 

125. 

204B. 

130. 

A.  D. 

130. 

205. 

134. 

206. 

134. 

207. 

134. 

208. 

138. 

209. 

142. 

210. 

144. 

211. 

147. 

212. 

148. 

213. 

153. 

214. 

155. 

215. 

157. 

216. 

160. 

217. 

173. 

218. 

173. 

219. 

173. 

220. 

173. 

221. 

174. 

222. 

174. 

223. 

190. 

224. 

190. 

225. 

195. 

226. 

199. 

227. 

201. 

228. 

201. 

229. 

205. 

230. 

208. 

231. 

213. 

232. 

218. 

233. 

222. 

234. 

225. 

235. 

227. 

236. 

232. 

237. 

235. 

Kidneys  and  Bladder,  in  sitti, 

Kidney,  Structure  of, 

Pyramids  of  Ferrein, 

Renal  Vessels, 

Corpora  Wolffiana, 

Urinary  Bladder, 

Sphincter  Vesicse, 

Tubuli  Testis, 

Vesiculse  Seminales, 

Penis, 

Circular  Fibres  of  Penis, 

Arterise  Helicinae, 

Perineum,  Muscles  of, 

Viscera  of  Female  Pelvis, 

Uterus, 

Corpus  Luteum, 

Corpora  Lutea, 

Lactiferous  Ducts, 

Secreting  Cells  of  Mammary  Gland, 

Follicles  of  Mammary  Gland, 

Larynx, 

Muscles  of  Larynx, 

Ventricle  of  Larynx, 

Trachea  and  Bronchia, 

Semilunar  Cartilages  of  Bronchia, 

Thymus  Gland, 

Lungs, 

Air  Vesicles  of  Lungs, 

Capillaries  of  Lungs, 

Capillaries  of  Intestinal  Villi, 

Capillaries  of  Mucous  Crypts, 

Capillaries  of  Parotid  Gland, 

Capillaries  of  Nervous  Centres, 

Capillaries  of  Conjunctiva, 

Capillaries  of  Choroides, 

Red  Corpuscles  of  Human  Blood, 

Red  Corpuscles  of  Frog's  Blood, 

Heart,  in  sitti, 

Tricuspid  Valve, 

Mitral  Valve, 

Semilunar  Valves  of  Aorta,  diagram  of 

Arteries  of  Chest  and  Neck, 

Arteries  of  Shoulder  and  Neck, 

Internal  Maxillary  Artery, 

Brachial  Artery, 

Arteries  of  Fore  Arm, 

Arteries  of  Hand, 

Descending  Aorta, 

Mesenteric  Arteries, 

Arteries  of  Thigh  and  Pelvis, 


Atlas,  see  Cloquet. 
«  « 

Schumlansky,  see  Caldani. 

Bowman. 

MUller. 

Santorini,  see  Atlas. 

Wistar  Museum,  see  Atlas. 

Lauth. 

Atlas,  see  Cloquet. 
«  « 

Horner,  from  Nature. 
M  tiller,  Physiology. 
Atlas,  see  Bougery,  &c. 
Wilson. 

Patterson,  see  Carpenter. 

Montgomery,  see  Carpenter. 

Cloquet. 

Cooper. 

Lebert. 

Atlas,  see  Cloquet. 


"     see  Bougery,  &c. 
Horner,  from  Nature. 
Atlas,  see  Cloquet. 

"  Bougery,  &c. 

Wistar  Museum,  see  Atlas. 
Carpenter. 
Berres. 


Wagner. 
« 

Atlas,  see  Bougery,  &c. 


Hazard. 

Atlas,  see  Bougery,  &c. 


«  «; 


Wilson. 
H 

Atlas,  see  Bougery,  &c. 

«  ti 

Cloquet. 
"  Bougery,  &c. 


ILLUSTRATIONS   TO  VOL.  II. 


XXIX 


PIG. 

FACE 

238. 

239. 

239. 

241. 

240. 

246. 

241. 

249. 

242. 

251. 

243. 

252. 

244. 

256. 

245. 

260. 

246. 

263. 

247. 

264. 

248. 

268. 

249. 

270. 

250. 

273. 

251. 

274. 

252. 

278. 

253. 

289. 

254. 

291. 

255. 

292. 

256. 

294. 

257. 

296. 

258. 

304. 

259. 

308. 

260. 

310. 

261. 

313. 

262. 

315. 

263. 

316. 

264. 

324. 

265. 

325. 

266. 

327. 

267. 

329. 

268. 

336. 

269. 

342. 

270. 

345. 

271. 

346. 

272. 

349. 

273. 

351. 

274. 

355. 

275. 

356. 

276. 

360. 

277. 

362. 

278. 

365. 

279. 

366. 

280. 

366. 

281. 

374. 

282. 

378. 

283. 

379. 

284. 

381. 

285. 

389. 

286. 

391. 

287. 

393. 

Arteries  of  Perineum, 

External  Iliac  and  Femoral  Arteries, 

Anterior  Tibial  Artery, 

Posterior  Tibial  Artery, 

Arteries  of  Foot, 

Veins  of  Face  and  Neck, 

Deep  Veins  of  Neck  and  Thorax, 

Veins  of  Upper  Extremity, 

Veins  of  Thigh, 

Veins  of  Leg, 

Veins  of  Trunk  and  Neck, 

Plan  of  Vena  Portarum, 

Foramen  Ovale  of  Foetal  Heart, 

Ventricles  of  Foetal  Heart, 

Foetal  Circulation, 

Lymphatics  of  Upper  Extremity, 

Lymphatics  of  Thigh, 

Lymphatics  of  Leg, 

Lymphatics  Pelvis  and  Loins, 

Lacteals, 

Thoracic  Duct, 

Nerve  Vesicles, 

Tubular  Nerve  Fibres, 

Tubular  Fibre,  Spinal  Nerve, 

Gray  Matter  of  Ganglia, 

Ganglion, 

Spinal  Marrow,  Pons,  &c. 

Spinal  Marrow,  Transverse  section  of 

Origins  of  Spinal  Nerves, 

Medulla  Spinalis, 

Dura  Mater  and  Sinuses, 

Medulla  Oblongata  and  Pons, 

Cerebellum, 

Cerebellum  and  Medulla  Oblongata, 

Diverging  Fibres  of  Brain, 

Base  of  Brain, 

Converging  Fibres  of  Brain, 

Ventricles  of  Brain, 

Ventricles  of  Brain  and  Fornix, 

Thalami  and  Corpora  Striata, 

Origin  of  Nerves  from  Brain, 

Olfactory  Ganglion, 

Olfactory  Pedicle, 

Arteries  of  Brain, 

Cartilages  of  Nose, 

Nasal  Cavities, 

Parietes  of  Nostril, 

Eyelids, 

Muscles  of  Eye, 

Lachrymal  Passages  and  Organs, 


Atlas,  see  Bougery,  &c. 


Wilson, 


Horner,  from  Nature. 


Atlas,  see  Bougery,  &c. 


Sharpey. 
Wilson. 
Valentin. 
Sharpey  &  Quain. 
Todd&  Bowman. 

Valentin. 
ii 

Atlas,  see  Cloquet. 


Quain  &  Sharpey. 
«  « 

Atlas,  see  Foville. 
«  « 

Atlas,  see  Gall  &  Spurzheim. 
Atlas,  from  Foville. 
Atlas,  from  Foville. 

Sharpey. 
tt 

tt 

Atlas,  from  Foville. 

Leidy. 
tt 

Wilson. 
ii 

Atlas,  from  Cloquet. 
«  « 

«  « 

Wilson. 

Atlas,  see  Caldani. 


XXX 


ILLUSTRATIONS   TO  VOL.  IT. 


FIG. 

PAGE 

288. 

395. 

289. 

400. 

290. 

402. 

291. 

403. 

292. 

406. 

293. 

407. 

294. 

408. 

295. 

412. 

296. 

413. 

297. 

416. 

298. 

419. 

299. 

426. 

300. 

428. 

301. 

431. 

302. 

437. 

303. 

438. 

304. 

439. 

305. 

441. 

306. 

448. 

307. 

450. 

308. 

454. 

309. 

459. 

3.10. 

464. 

311. 

474. 

312. 

476. 

313. 

478. 

314. 

482. 

315. 

484. 

316. 

486. 

317. 

488. 

318. 

489. 

319. 

489. 

320. 

490. 

Tensor  Tarsi  Muscle, 

Globe  of  Eye, 

Epidermis  on  Conjunctiva, 

Blood-vessels  of  Cornea, 

Pigmentum  Nigrum  of  Choroidea, 

Choroidea  with  its  Blood-vessels, 

Iris  and  Ciliary  Ligament, 

Ketina,  Capillaries  of, 

Ketina, 

Lens, 

External  Ear, 

Tympanum, 

Labyrinth, 

Membranous  Labyrinth, 

Nerves  of  Orbit, 

Nerves  of  Orbit, 

Trigeminus  Nerve, 

Otic  Ganglion, 

Facial  and  Cervical  Nerves, 

Hypoglossal  and  Cervical  Nerves, 

Eighth  Pair  of  Nerves, 

Great  Sympathetic  Nerve, 

Splanchnic  Nerve, 

Brachial  Nerves, 

Nerves  of  Fore  Arm, 

Nerves  on  Back  of  Fore  Arm, 

Lumbar  Plexus  and  Branches, 

Nerves  on  Front  of  Thigh, 

Branches  of  Ischiatic  Plexus, 

Nerves  in  Front  of  Leg, 

Branches  of  Popliteal  Nerve, 

Posterior  Tibial  Nerve, 

Nerves  of  Sole  of  Foot, 


Horner,  from  Nature. 

Wilson. 

Gerber. 

Toynbee. 

Gerber. 

Atlas,  from  Cloquet. 
«  it 

Berres. 

Treviranus. 

Brewster. 

Atlas,  from  Cloquet. 

Arnold,  see  Quain. 

Atlas,  from  Cloquet. 
««  it 

Sharpey. 

Quain  and  Sharpey. 

Bell. 

Arnold. 

Atlas,  from  Quain,  &c. 


Wilson. 


Wilson. 
Quain,  &c. 

a 

Wilson. 


BIBLIOGRAPHY: 

WORKS  REFERRED  TO  IN  THE  FIGURES,  OR  RECOMMENDED. 


ELEMENTS  of  Physiology,  by  J.  Mviller.    Translated  by  W.  Baly.    London,  1840. 

Elements  of  Gen.  and  Minute  Anatomy,  by  Fr.  Gerber.  Translated  by  Geo. 
Gulliver.  London,  1843. 

Manuel  d' Anatomic  G6n6rale,  par  L.  Mandl.     Paris,  1843. 

Physiol.  Anatomy,  Todd  and  Bowman.     London,  1843. 

Cycloped.  of  Anat.  and  Physiology.     London,  1836. 

Human  Anatomy,  by  Erasmus  Wilson.     London.     Philada.  edit.,  1847. 

Human  Anatomy,  by  Jones  Quain.  Edited  by  Quain  and  Sharpey.  Phila. 
edition,  1849.  From  fifth  London. 

Elements  of  Physiology,  by  Rudolph  Wagner.  Translated  by  Rob.  Willis,  M.  D. 
London,  1841. 

Icones  Anatomicse,  Caldani.     Venitiis,  1818. 

Anatomie  de  THomme,  par  Jul.  Cloquet.     Paris,  1828. 

Anatomia  Microscopica,  Berres.     Yienna,  1836. 

Practical  Treatise  on  the  Microscope,  by  John  Queckett.     London,  1848. 

Microscopic  Anatomy,  by  Arthur  Hill  Hassall.     London,  1849. 

Principles  of  Human  Physiology,  by  W.  B.  Carpenter,  of  London  University. 
Philadelphia  edition,  1850. 

Cours  de  Microscopie,  par  Al.  Donn6.    Paris,  1844. 

Bougery  and  Jacob,  Anat.  de  PHomme.    Paris,  1835. 

Herniarum  Corp.  Human.  Tabulae.    Petropolitani,  1835. 

Gall  et  Spurzheim,  Recherches  sur  le  Systeme  Nerveux,  &c.     Paris,  1809. 

Foville,  Traite"  de  TAnat.,  &c.     Paris,  1844. 

Anatomical  Atlas,  by  H.  H.  Smith,  M.  D.  Under  supervision  of  W.  E.  Horner, 
M.  D.,  Prof.,  &c.  Philada.  1844. 

Catalogue  of  the  Wistar  Museum  of  the  University  of  Pennsylvania.  Third 
edition.  By  W.  E.  Horner,  M.  D.,  Prof,  of  Anat.  Phila.,  1850. 

When  the  Wistar  Museum  is  referred  to  in  connection  with  any  of  the  foregoing 
illustrations,  it  means,  almost  without  exception,  that  the  preparation  was  exe- 
cuted by  Dr.  Horner,  though  the  figure  may  have  been  originally  presented  in  the 
Anatomical  Atlas,  or  elsewhere. 

The  writer,  in  endeavoring  to  credit  each  author  for  his  figures,  laments  his  ina- 
bility to  do  justice  in  every  case,  owing  to  the  intermixture  which  has  occurred  in 
the  progress  of  time.  It  would  benefit  much  the  cause  of  science,  if  every  writer 
had  been  careful  to  assign  correctly  the  origin  of  his  figures,  specially  in  each  in- 
stance ;  and  particularly  whether  they  were  from  nature ;  or  mere  modifications  of 


XXX11  BIBLIOGRAPHY. 

figures  already  published,  a  practice,  unhappily,  too  much  followed.  From  such 
omissions,  it  is  extremely  difficult  to  know,  in  some  instances,  to  whom  the  first 
credit  is  due,  and  errors,  therefore,  among  us  are  almost  unavoidable,  from  the 
want  of  a  good  sequence  of  authority  from  the  original.  I  have  endeavored  to 
make  proper  references  of  authority,  even  when  there  was  neither  elevated  merit 
nor  originality  in  the  figure  ;  but  should  any  material  omission  have  occurred,  shall 
regret  it  much,  with  the  desire  to  amend  it  on  a  future  occasion.  The  celebrated 
work  of  Caldani,  containing  the  reproduction  of  the  best  anatomical  figures  up  to 
his  day,  but  by  him  properly  accredited  to  their  authors,  has  been  a  very  prolific 
mine  for  such  as  like  to  do  but  little  in  the  way  of  practical  anatomy  for  themselves  ; 
and  the  vestiges  of  it  are  seen  in  every  direction  in  figures  of  reduced  size  and  so  on, 
without  due  acknowledgment  to  him  or  to  the  authority  which  he  has  himself  very 
honestly  quoted.  An  examination  of  its  pages  will  show  that  it  has  been  in  fact 
the  most  fertile  supply  for  transpositions  and  for  reductions  in  size  to  be  found 
in  the  profession ;  and  though  this  originating  source  is  very  evident  in  a  great 
number  of  figures  accredited  to  others  in  these  references,  I  have  thought  it,  per- 
haps, better  not  to  disturb  the  account,  at  least  for  the  present. 


INTRODUCTION. 


CHAPTER  I. 

HISTOLOGY,  OR  GENERAL  ORGANIZATION  OF  THE  HUMAN 

BODY. 

IN  passing  the  eye  over  the  structure  of  the  human  body,  it  is  evident 
that  the  latter  is  formed  by  an  aggregation  of  organs  and  of  textures  : 
each  adapted  to  some  particular  function  of  a  vital  or  of  a  mechanical 
kind  ;  the  apparatus  of  the  two  functions,  vital  and  mechanical,  being 
in  many  instances  blended.  Some  of  the  organs  are  of  a  character  so 
peculiar  that  their  texture  is  repeated  nowhere  else  ;  other  organs 
have  their  texture  exactly  renewed  in  numerous  places  ;  a  good  exam- 
ple of  which  is  seen  in  the  muscles,  where,  from  the  necessity  of  motion, 
muscular  structure  exists  at  many  points,  both  for  locomotion  and  for 
the  internal  operations  of  the  body.  Anatomy  as  a  science  has  for  its 
object  to  portray  all  these  component  parts,  both  solid  and  fluid,  under 
whatever  circumstances  they  may  be  presented. 

The  application  of  the  science  to  the  search  of  the  same  texture  in 
different  organs,  and  wherever  it  may  indeed  be  found  ;  the  tracing  of 
its  degree  of  extension  and  its  modifications  under  all  circumstances  ; 
in  fine,  a  general  comparison  of  it,  one  parcel  with  another,  constitutes 
what  is  called  General  Anatomy,  or  Histology.1  Each  individual  tex- 
ture is  in  technical  language  a  tissue. 

Special  or  Descriptive  Anatomy,  in  distinction  from  Histology, 
teaches  the  exterior  form  of  organs,  their  magnitude,  their  position, 
their  connections  with  adjacent  parts  ;  and  their  intimate  texture  or 
organization.  As  in  this  way  every  individual  part  is  brought  under  a 
strict  review,  it  is  the  knowledge  of  this  portion  of  the  science  which 
gives  skill  to  the  surgeon. 

General  Anatomy  may  be  explained,  as  its  great  founder,  Bichat, 
himself  has  done  it,  by  the  following  comparison.  Chemistry  has  its 


1  From  IO-TO;  texture,  and  Xoyof  word,  doctrine  of  texture. 
VOL.  I.—  3         ' 


34  HISTOLOGY. 

simple  bodies,  as  heat,  light,  hydrogen,  oxygen,  nitrogen,  carbon,  and 
so  on,  whose  several  combinations  form  all  the  composite  bodies  on  the 
face  of  the  globe.  In  the  same  way  anatomy  has  its  simple  tissues, 
whose  varied  combinations  form  all  the  organs  of  the  human  body  and 
of  animals. 

Bichat  admits  twenty-one  elementary  tissues,  but  several  of  them 
are  but  modifications  of  one  and  the  same. 

Many  other  modes  of  classification  have  been  proposed  since  Bichat's; 
they  have  for  the  most  part  been  received  by  the  profession  with  indif- 
ference, as  not  furnishing  sufficient  inducements  for  a  change.  That 
of  Bichat  originating  with  himself  has  become  so  completely  identified 
with  the  ordinary  language  of  anatomy  and  pathology,  that  it  is  by  no 
means  probable  that  it  can  be  supplanted  by  any  other.  Among  the 
most  modern  of  the  suggestions  of  change  are  those  of  Schwann,  who 
proposes  a  classification  of  tissues  upon  the  basis  of  their  cellular  histo- 
geny.  Valentin  and  Gerber  have  also  made  efforts  at  a  new  system, 
and  have  had  no  better  success  than  their  predecessors.1.  Some  sub- 
divisions and  additions  have  been  made  with  advantage  under  the  im- 
proved application  of  the  microscope,  but  no  general  renewal  can  take 
place  at  present  upon  existing  grounds  of  information. 

The  following  distribution  will  include  the  ideas  of  Bichat  as  quali- 
fied by  the  actual  state  of  microscopic  anatomy.  The  primary  tissues 
having  characters  absolutely  distinct  from  all  others,  and  the  secondary 
being  merely  modified  forms  of  the  primary. 

PRIMARY  TISSUES.  SECONDARY  TISSUES. 

a.  Serous  membrane,  as  pleura. 
6.  Synovial  membrane,  as  in  joints. 
c.  Inelastic  fibrous  tissue,  as  in  tendons. 


I. — The  Cellular  or  Areolar.  - 


d.  Elastic  fibrous  tissue,  as  in  yellow  ligament. 


e.  Vascular  tissue,  as  in  blood-vessels   and  ab- 

sorbents. 

f.  Cutaneous  or  dermic. 
Erectile  or  spongy. 

f  a.  Basement  membrane. 
IL-Simple  Membranous.      |  ft>  Posterior  ^  of  cornea>  capsule  of  crystalline. 

ca.  Elain. 

III. — Adipose  tissue.  -J  b.  Stearin. 

(  c.  Margarin. 

Cuticle. 

IV. — Epidermic.  «j  6.  Hair. 

Nails. 

Rete  mucosum  of  skin. 
Pigmentum  nigrum  of  eye. 

1  See  Encyclop.  Anat.  vol.  vi.  p.  131,  Paris,  1843. 


V. — Pigmentary.  .  j    ' 


TISSUES.  3.5 


f  a.  Cerebro-spmal  axis. 
VIII. — Nervous. 

(b. 


(  a.  Alimentary  canal,  &c. 
VI.-Mucous.  |6    Nasal  sinuses. 

(  a.  Animal  life  or  striated. 
VII.— Muscular.  j  ^  Organic  life  or  n0n-striated. 

Cerebro-spinal  axis. 
Nerves,  animal  and  organic. 

( a.  Pure  cartilage. 

IX.— Cartilaginous.  4  _    _..  t..  & 

|  b.  Fibro-cartilage. 

f  a.  Skeleton. 
X. — Osseous.  •!  b.  Dentine  and  enamel  of  teeth. 

I  c.  Crusta  petrosa  of  teeth. 

ta.  Follicles. 
XI.— Glandular.  -j  b.  Tubes  of  marked  length. 

(  c.  Racemose  or  branched  tubes. 

f  a.  Blood. 
XII. — Corpuscular."]  «6.  Lymph. 

(c.  Chyle. 

The  distinctions  of  tissue  do  not  .rest  upon  an  imaginary  basis,  but 
have  nature  for  their  foundation.  The  organization  of  each  has  well- 
marked  and  characteristic  peculiarities,  which  may  be  ascertained  by 
their  diseases,  and  by  the  influence  of  different  agents,  as  heat,  air, 
water,  acids,  alkalies,  neutral  salts,  and  putrefaction.  Each  tissue  has 
its  particular  strength,  and  its  particular  mode  of  sensibility,  upon 
which  repose  all  its  vital  phenomena,  and  the  blood  is  but  a  common 
reservoir,  where  each  chooses  what  is  in  relation  to  itself.  An  example, 
however,  will  serve  better  for  illustrating  these  several  points.  The 
stomach  is  composed  of  four  laminae ;  one  is  serous,  another  muscular,  a 
third  cellular,  and  a  fourth  mucous.  Each  of  these  laminae  has  its  ap- 
propriate sensibilities  and  mode  of  life,  which  may  cause  it  to  be  dis- 
eased, while  all  the  others  are  healthy.  Peritoneal  inflammation  may 
invade  the  first,  the  cramps  of  colic  the  second  or  muscular,  the  infiltra- 
tion of  dropsy  the  third  or  cellular,  and  dyspepsia  the  fourth  or  mucous. 

The  several  tissues  may,  therefore,  be  considered  as  animal  matters, 
endowed  each  with  its  own  especial  vital  force  and  physical  properties, 
from  the  union  of  which  results  the  especial  physiological  action  of  the 
part  under  consideration. 

It  thus  happens,  that  the  diversity  of  the  tissue  of  an  affected  organ 
modifies  the  symptoms  of  its  diseases,  and  particularly  their  duration. 
Hence,  nothing  is  more  vague  in  medicine,  in  regard  to  duration,  than 
the  terms  chronic  and  acute.  An  inflammation  in  one  tissue  will  go 
naturally  through  its  stages  in  a  few  days,  as,  for  example,  in  the  skin, 
cellular  substance,  mucous  membranes;  while  in  the  bones  and  liga- 
ments, on  a  natural  progress  being  also  observed,  weeks  and  months 


36  HISTOLOGY. 

are  required  for  its  accomplishment.  It  is  evident,  therefore,  that  a 
time  which  is  chronic  in  the  first  three  tissues  is  acute  in  the  last  two. 

A  chemical  analysis  of  the  body  demonstrates  only  a  few  elementary 
principles  ;  and  they  are  varied  in  their  combinations  by  a  greater  or 
less  proportion  of  one  or  the  other.  Calcareous  matter,  the  neutral 
salts,  carbon,  hydrogen,  oxygen,  nitrogen,  sulphur,  iron,  wrought  up 
by  the  powers  of  animalization  into  gelatin,  albumen,  and  fibrin, 
which  again  are  elaborated  into  the  filamentous  and  laminated  tissue, 
constitute  nearly  the  sum  total  of  the  results  of  the  experiments  of 
animal  chemistry.  It  has  yet  to  find  out  the  laws  which  give  to  these 
elementary  atoms  the  condition  of  blood,  and  afterwards  change  this 
blood  into  muscles,  nerves,  and  other  tissues. 

The  whole  body  is  formed  of  solids  and  of  fluids.  The  former,  when 
unraveled,  consist  of  filaments,  of  laminae,  and  of  molecules ;  their 
mechanical  division  does  not  admit  of  any  greater  separation.  Many 
of  the  laminae  are  arranged  into  membranes,  thus  forming  hollow 
viscera,  for  containing  either  articles  of  food  or  the  excretions  ;  others 
surround  the  different  solid  viscera  and  separate  them  from  the  con- 
tiguous parts.  Other  laminae  penetrate  through  the  most  compact 
structure,  and  indeed  form  the  nidus  in  which  its  atoms  or  particles 
are  deposited.  Many  of  these  laminae  consist  of  several  thinner 
laminae,  placed  together  and  united  by  filaments  arranged  into  cells, 
which  cells  receive  the  ultimate  particles  of  the  whole  fabric,  and  con- 
stitute its  base.  The  laminae  also,  by  being  wrought  into  cylinders, 
constitute  vessels  of  different  kinds,  which  are  distributed  in  such 
number  through  the  body  that  by  far  the  greater  part  of  its  structure 
seems  to  be  formed  of  them.  In  regard  to  the  fluids,  they  are  ex- 
tremely abundant  in  number  and  in  quantity,  and  are  found  in  the  cells 
of  the  laminated  tissue,  and  in  the  several  vessels.  One  not  accus- 
tomed to  the  process  would  be  astonished  to  see,  when  these  fluids 
evaporate  by  exposure  to  the  air,  that  nearly  all  parts  of  the  body, 
except  the  skeleton,  lose  from  one-half  to  two-thirds  of  their  original 
bulk,  and  some  parts  even  more.  The  several  solid  parts  of  the  body 
are  then  literally  kept  soaked  during  life  in  the  fluids ;  which  have  for 
a  principal  constituent  simply  water. 

There  are  some  animals  whose  organization  is  so  simple,  that  they 
possess  only  the  power  of  sensation,  and  of  motion  in  one  part  upon 
another.  This  is  perhaps  the  lowest  degree  in  which  animal  life  does 
exist,  or  possibly  can  exist  without  a  new  order  of  things.  These  quali- 
ties, sensation  and  motion,  are  of  necessity  combined  always  ;  they 
constitute  the  first  ingredients  in  the  composition  of  life,  both  in  vege- 
tables and  animals,  and  by  being  modified  in  various  ways  by  their  appli- 
cation to  different  organs,' may  be  traced  up  to  the  perfect  animal,  man. 


CIRCULATION.  37 

Nutrition  is  the  first  want  of  every  being,  and  is  one  of  the  modes  of 
sensation  ;  therefore,  before  any  other  apparatus  is  provided  for  animal 
life,  means  are  resorted  to  to  carry  it  on.  Vegetables  are  fixed  to  the 
soil,  and  are  furnished  with  great  numbers  of  porous  roots,  which,  by 
spreading  in  different  directions,  come  in  contact  with  the  moisture  of 
the  ground  and  by  simple  absorption  conduct  it  as  the  aliment  of  the 
plant.  There  are  many  animals  which  have  a  vegetative  life  almost  as 
simple  as  this,  and  are  fixed  permanently  to  the  spot  where  they  came 
into  existence  ;  others  are  permitted  to  change  their  places  of  abode, 
and  a  provision  for  nourishment  by  roots  would  not  answer ;  hence 
comes  the  necessity  of  a  stomach,  or  reservoir  in  the  interior  of  the 
body,  into  which  aliment  may  be  introduced  and  transported  along 
with  the  animal.  In  many  instances  this  stomach  seems  to  constitute 
the  whole  animal,  as  in  a  hydatid :  it  receives  such  simple  fluids  as 
compose  the  medium  in  which  it  resides,  and  carries  on  its  digestion, 
with  so  little  change  of  the  alimentary  matter,  that  there  seems  to  be 
nothing  of  an  excrementitious  kind,  as  commonly  understood,  thrown 
off.  These  animals  are  found  abundantly  in  the  waters  of  tropical 
regions,  exist  sometimes  in  the  brain  of  man,  and  of  sheep ;  in  the 
uterus,  and  in  almost  every  part  of  the  body.  But,  again,  there  are 
stomachs  of  a  more  complex  kind,  which  have  opening  into  them  a 
great  number  of  absorbing  orifices,  called,  in  the  striking  language  of 
Boerhaave,  "  genuine  internal  roots."  These  stomachs  may  admit 
fluids  only,  or  they  may  be  large  enough  to  receive  considerable  masses 
of  solid  aliment.  In  the  latter  case  exists  the  necessity  of  teeth,  or 
some  mechanical  means  of  triturating  the  solid  food  into  such  fine 
pieces  as  will  admit  of  its  being  exposed  by  an  extensive  surface  to 
the  action  of  the  stomach.  But  as  much  of  the  matter  thus  carried  in 
is  unfit  for  assimilation,  and  there  may  be  even  more  of  it  than  is 
required,  an  intestinal  canal  is  provided,  by  which  it  is  carried  out 
again.  Here  then  commence  the  phenomena  of  a  true  digestion,  with 
all  its  modifications  and  stages. 

The  very  simple  structure  of  a  plant  and  its  permanent  locality  are 
attended  with  a  circulation  of  its  juices  equally  simple  ;  which  is  per- 
formed and  maintained  by  the  capillary  attraction  of  its  pores,  and  by 
evaporation  from  its  higher  and  more  exposed  parts.  This  circulation 
is  the  more  rapid  as  the  evaporation  becomes  greater  ;  but  the  latter 
may  become  changed  into  absorption  by  the  humidity  of  the  atmo- 
sphere ;  and  the  circulation  be  as  a  consequence  reversed  from  the 
branches  to  the  roots.  But  it  is  evident  that  such  animals  as  possess 
extensively  the  powers  of  locomotion,  besides  having  organs  more 
numerous  and  more  complex  than  the  parallel  fibrillse  of  vegetables, 


38  CIRCULATION. 

will  frequently  find  themselves  in  such  conditions  of  temperature  and 
locality,  that  a  similar  circulation  of  the  nutritious  fluid  in  them  could 
not  be  maintained.  Hence  it  is  necessary  to  have  more  powerful  and 
regular  agents  for  carrying  on  the  circulation.  They,  therefore,  are 
furnished  with  innumerable  blood-vessels,  called  arteries  and  veins ; 
which  have  a  common  centre,  the  heart,  for  propelling  through  them 
the  blood,  or  nutritive  fluid,  to  all  parts  of  the  system.  From  the  heart 
being  furnished  with  valves,  which  are  all  in  one  direction,  the  blood 
can  flow  only  in  a  corresponding  course ;  thus  it  is  forced  by  the  heart 
into  the  arteries,  and  after  moistening  the  most  minute  fibres  it  is 
received  into  the  capillary  extremities  of  the  veins  and  brought  back  to 
the  heart,  where  it  receives  another  impulse,  and  performs  again  the 
round  of  the  body  and  so  on  in  succession.  This  phenomenon  is  called 
the  Circulation.  When  it  exists  in  animals,  blood  is  always  to  be  found  ; 
for  the  most  part  red,  but  in  many  species  white  or  transparent.  The 
use  of  the  blood  in  them  is  to  receive  from  the  alimentary  canal,  from 
the  skin  and  lungs,  such  matter  as  has  been  assimilated,  and  to  convey 
it  to  every  part  of  the  body,  for  the  purpose  of  repairing  its  waste,  or 
providing  for  its  growth.  It  is  at  the  very  extremities  of  the  arteries 
that  this  deposit  occurs,  and  the  blood  getting  into  the  veins  loses  its 
bright  vermilion  color,  becomes  of  a  modena  or  dark  blue,  and  is  no 
longer  fit  for  the  purposes  of  life  till  some  of  the  principles  which  it 
has  lost  by  this  passage  are  restored  to  it.  This  restoration  takes 
place  in  the  lungs,  where  a  sort  of  combustion  is  performed  by  the 
absorption  of  oxygen.  This  process  is  called  Respiration,  and  it  exists 
in  all  things  that  live,  under  various  modifications  of  the  apparatus 
performing  it.  In  man  it  is  performed  in  two  cellular  air  bags,  which 
have  a  heart  independent  of  the  one  just  mentioned,  for  propelling  the 
blood  through  the  ramifications  of  their  vessels.  In  fish  there  are  gills, 
which  have  their  surfaces  exposed  to  the  water,  and  are  aerated  by  the 
air  contained  in  the  water,  and  the  same  heart  which  supplies  the 
general  circulation  also  fills  a  large  artery  that  is  distributed  very 
minutely  through  the  gills.  But  in  insects,  where  there  are  no  blood- 
vessels, and  the  nutritious  fluid  is  contained  in  cells,  there  are,  distri- 
buted over  their  bodies,  air-tubes,  which  transmit  atmospheric  influence. 
The  blood-vessels,  in  addition  to  the  function  of  carrying  nutritious 
matter,  perform  an  essential  part  of  a  very  different  character.  All 
the  atoms  of  which  the  body  is  composed,  after  residing  in  it  for  a 
time,  become  no  longer  fit  for  use ;  their  farther  residence  is,  in  fact, 
injurious,  and  it  is  necessary  to  remove  them.  A  system  of  vessels  is 
provided  for  this  purpose  called  the  absorbents,  which  are  the  scaven- 
gers of  the  body.  Taking  up,  therefore,  these  effete  atoms,  they  con- 


SENSATION.  39 

vey  them  into  the  blood-vessels,  where  they  are  mixed  with  the  common 
mass  of  blood.  Several  organs  are  provided,  as  the  liver,  the  kidneys, 
the  surface  of  the  body,  and  the  lungs,  through  which  these  effete 
particles  are  discharged  from  the  blood  in  the  form  of  excretions;  as 
the  bile,  the  urine,  perspiration,  and  pulmonary  exhalation. 

We  have  now  sketched  the  human  machine  as  far  as  its  internal 
existence,  or  self-preservation,  is  concerned  in  the  functions  of  diges- 
tion, circulation,  respiration,  and  excretion.  Let  us  proceed  in  the 
inquiry  by  a  rapid  glance  at  those  organs  by  which  it  is  put  into 
relation  with  surrounding  objects,  and  on  which  it  depends  for  the 
sublime  operations  of  the  understanding. 

Sensation  is  derived  from  the  nervous  system,  composed  of  the  brain, 
the  spinal  marrow,  and  the  nerves.  The  latter  may  be  traced  to  many 
parts  of  the  body,  and  are  supposed  to  be  distributed  to  all.  They 
maintain  its  different  sympathies,  keep  the  several  organs  in  one  har- 
monious course  of  action,  and.  in  some  instances  at  least,  are  indis- 
pensable to  the  performance  of  their  functions.  In  addition  to  these, 
many  of  the  nerves  have  at  their  extremities  organs  of  a  particular 
construction,  each  fashioned  in  the  best  manner  for  the  execution  of 
its  office  in  making  us  acquainted  with  exterior  objects.  The  interior 
extremities  of  all  these  nerves  terminate  either  in  the  brain  or  spinal 
marrow ;  the  external  are  the  points  intended  by  nature  to  be  affected 
by  the  objects  around  us ;  but  it  is  indispensable  to  consciousness  that 
their  line  of  communication  with  the  brain  be  not  interrupted.  The 
sense  most  extended  is  that  of  the  touch,  which  is  enjoyed  by  all  parts 
of  the  surface  of  the  body ;  the  others  are  thought,  by  very  respectable 
physiologists,  to  be  only  more  exalted  modifications  of  it,  and  are  sus- 
ceptible of  more  delicate  impressions.  It  is  scarcely  necessary  to 
mention  that  the  other  sensations  are  executed  by  the  eye,  the  ear,  the 
tongue,  and  the  nose. 

The  Sense  of  Touch  is  the  most  important  of  all,  and  the  least  liable 
to  error  in  its  reports.  To  exercise  it,  it  is  necessary  for  the  body 
under  examination  to  come  into  contact  with  ours ;  hence,  its  operations 
are  so  mechanical  that  but  little  is  left  to  the  imagination,  and  they, 
therefore,  serve  to  verify  and  to  correct  the  impressions  on  the  other 
senses,  more  particularly  those  on  the  eye.  It  is  the  sense  of  touch 
by  which  we  learn  accurately  the  dimensions  of  bodies,  and  the  figures 
of  such  as  are  hard.  The  hand,  or  any  other  part,  by  being  applied 
to  them  in  various  directions,  informs  us  whether  they  are  flat,  round, 
or  angular.  A  greater  or  less  degree  of  pressure  informs  us  whether 
they  are  soft  or  hard,  and,  by  rubbing,  we  ascertain  whether  they  are 


40  SENSATIONS. 

rough  or  polished.  The  resistance  they  make  to  motion  teaches  us 
whether  they  can  or  cannot  be  moved,  and  their  being  impelled  against 
us  shows  the  momentum  with  which  they  act,  as  well  as  its  direction. 
Our  ideas  of  heat  and  of  cold  are  also  derived  from  this  source.  It  is 
not  asserted  that  all  parts  of  the  surface  of  the  body  enjoy  equally  the 
sense  of  touch ;  on  the  contrary,  this  sensibility  is  more  or  less  active 
according  to  the  organization  of  the  part,  and  as  its  nerves  are  more 
or  less  numerous  and  exposed ;  hence  we  find  it  most  exquisite  and 
perfect  in  the  ends  of  the  fingers.  This,  therefore,  being  the  most 
important  of  the  senses,  the  magnitude  of  its  influence  on  the  habits 
and  intelligence  of  different  animals  is  immense. 

Man,  from  the  nudity  and  the  delicacy  of  the  texture  of  his  skin, 
derives,  from  this  source,  a  discrimination  and  refinement,  in  regard  to 
the  nature  of  bodies,  much  superior  to  what  many  other  animals  possess. 

The  Sight  enables  us  to  distinguish  the  color,  the  quantity,  and  the 
directions  of  the  rays  of  light  which  proceed  from  a  luminous  body ; 
or,  in  other  words,  to  ascertain  its  situation,  size,  and  figure.  In  each, 
however,  of  the  latter  we  are  exposed  to  great  deception ;  for  the  rays 
of  light,  by  falling  on  a  mirror,  or  any  other  plane  reflecting  surface, 
before  they  reach  the  eye,  will  induce  us  to  believe  the  body  to  be  in 
that  direction.  Bodies  which  are  near  reflect  more  rays  of  light  than 
such  as  are  distant:  we  thus  estimate  distance  by  the  eye;  but  it 
happens  continually  that  some  bodies  naturally  reflect  more  rays  than 
others,  in  consequence  of  which  a  very  luminous  body,  at  a  great  dis- 
tance, will  frequently  be  thought  to  be  much  nearer  to  us,  than  such 
as  are  more  within  our  reach.  Mistakes  of  this  kind  can  only  be  corrected 
by  the  sense  of  touch,  and  our  habitual  reference  to  it,  and  continued 
experience,  finally  enable  us  to  form  prompt  and  just  decisions.  The 
eye,  however,  infinitely  exceeds  the  touch  in  the  rapidity  with  which 
it  communicates  ideas,  and  also  in  the  extensiveness  of  its  application 
in  a  single  moment.  It  is,  therefore,  an  organ  of  the  first  utility  in 
making  us  acquainted  with  surrounding  objects.  Man  does  not  possess 
it  to  that  great  perfection  that  some  other  animals  do ;  he  can  neither 
see  so  far  as  the  vulture  or  eagle,  nor  so  minutely  as  the  fly;  yet  his 
ingenuity  has  enabled  him  to  excel  both.  For,  with  the  telescope,  he 
examines  worlds  in  the  immensity  of  space,  which,  under  common 
examination,  are  either  invisible  or  form  mere  points  in  the  heavens, 
and  with  the  microscope  he  sees  the  texture  of  the  most  minute  object. 

The  Ear,  along  with  the  powers  of  articulation,  enables  the  whole 
human  family  to  make  common  stock  of  the  knowledge  which  each 
individual  may  possess.  As  connected  with  the  preservation  of  the 


VITAL  FUNCTIONS.  41 

individual,  it  is  much  less  important  than  the  eye  or  the  touch ;  yet, 
considering  it  as  a  means  by  which  we  receive  knowledge  and  impart 
it  to  others,  the  aggregate  of  human  intellect  depends  for  its  present 
state  and  future  improvement  essentially  upon  it.  In  its  acuteness,  we 
are  much  inferior  to  many  other  animals  ;  neither  have  we,  by  instru- 
ments, been  able  to  do  much  in  improving  it ;  yet,  by  cultivation  and 
by  studying  its  most  minute  and  delicate  impressions,  an  endless 
source  of  instruction  and  amusement  has  been  opened  to  us  in  the 
intonations  of  language,  and  in  the  enrapturing  strains  of  harmony. 
It  eminently  qualifies  man  for  the  social  state,  occasionally  warns  him  of 
danger,  and  allures  him  to  such  things  as  are  useful  to  his  subsistence. 

In  regard  to  the  Taste  and  to  the  Smell,  they  make  us  acquainted 
only  with  such  objects  as  are  necessary  to  our  subsistence.  They  are 
enjoyed  too  imperfectly  by  man  for  them  to  become  a  fruitful  source 
of  his  intelligence.  As  they  principally  lead  us  to  filling  the  stomach, 
and  to  debasing  the  intellectual  man  into  the  beast,  that  eats  and  dies, 
the  wisdom  of  nature  is  as  fully  demonstrated  in  the  imperfection  which 
she  has  put  upon  these  senses,  and  in  our  inability  to  improve  them, 
as  in  the  exalted  and  varied  degrees  to  which  she  has  carried  the  others. 
The  keenness  of  the  scent  of  the  hound,  and  the  discriminating  nicety 
of  the  bee,  in  opening  sources  of  enjoyment  merely  physical,  would 
have  degraded,  instead  of  elevating  us,  by  engrossing  our  time  and 
ingenuity  in  the  development  of  pleasures  incompatible  with  our  con- 
stitutions and  destinies. 

Man  being  thus  organized,  it  is  worthy  of  inquiry  in  what  his  life  con- 
sists. According  to  the  celebrated  Bichat,  it  is  "the  aggregate  of  those 
functions  by  which  death  is  resisted.  For  such,  indeed,  is  the  condition 
on  which  we  live,  that  every  thing  surrounding  us  has  a  tendency  to 
produce  our  dissolution,  by  the  affinities  existing  between  their  atoms, 
and  the  atoms  of  which  a  living  body  is  composed.  It  is  plain,  there- 
fore, that  the  principle  of  life,  like  all  other  principles  in  nature,  incom- 
prehensible in  itself,  must  be  studied  by  its  phenomena."1 

There  are  two  remarkable  modifications  of  life ;  one  is  common  to 
the  vegetable  and  to  the  animal,  the  other  is  the  exclusive  attribute  of 
the  latter.  Under  the  first  modification,  are  included  assimilation  and 
excretion,  which,  though  exercised  under  apparently  different  circum- 
stances in  animals  and  in  plants,  are  probably  essentially  the  same  in 
both.  This  modification  is  termed  by  Bichat,  Organic  Life.  By  the 
second  modification  of  life,  the  animal  has  a  more  extended  sphere  of 

•  Recherches  sur  la  Vie  et  La  Mort. 


42  VITAL  FUNCTIONS. 

existence  than  the  vegetable,  is  put  into  a  certain  relation  with  all  the 
objects  that  surround  him,  is  made  the  inhabitant  of  the  whole  world, 
and  not,  like  the  vegetable,  confined  for  ever  to  the  place  of  its  birth. 
By  it  the  animal  feels,  and  is  conscious  of  external  objects,  reflects 
upon  them,  moves  voluntarily,  and  can  communicate,  by  the  voice,  his 
wants  and  apprehensions,  his  pleasures  and  his  pains.  The  functions 
included  under  the  second  modification  are  termed,  by  Bichat,  Animal 
Life. 

Each  of  these  lives  has  two  orders  of  functions,  keeping  up  its  con- 
nection with  the  objects  destined  for  its  existence.  In  animal  life,  one 
of  these  orders  may  be  said  to  commence  at  the  surface  of  the  body, 
and  to  be  extended  towards  the  centre,  the  impression  of  exterior  objects 
affecting  first  the  senses,  then  the  trunks  of  nerves,  and  lastly,  the  brain. 
A  second  movement,  constituting  the  second  order  of  functions,  is  after- 
wards made  from  the  centre  to  the  circumference,  by  which  the  influence 
of  the  brain  is  exercised  on  the  organs  of  locomotion  and  of  voice. 
These  two  functions,  in  animal  life,  are  perfectly  equivalent  in  their 
operations.  He  who  feels  the  most,  will  also  act  the  most.  Early  life 
is  the  period  of  quick  and  multiplied  sensations,  so  is  it  the  period  of 
quick  and  multiplied  movements.  A  partial,  or  a  total  privation  of  the 
sense  of  sight,  causes  us  to  move  cautiously  and  slowly  onwards.  The 
suspension  of  our  communication,  through  sleep,  with  exterior  objects, 
causes  also  a  suspension  of  the  faculties  of  locomotion  and  of  voice. 

In  organic  life,  the  first  order  of  functions  assimilates  to  the  animal 
the  substances  which  must  nourish  him,  and  includes  digestion,  circula- 
tion, respiration,  and  nutrition ;  under  the  influence  of  which  four  func- 
tions, everything  must  pass  before  it  can  be  assimilated.  But,  after 
a  temporary  residence,  the  assimilated  particles,  becoming  effete  and 
noxious,  have  to  be  carried  away  out  of  the  body :  by  which  means  the 
second  order  of  functions  in  organic  life  is  established,  consisting  of 
absorption,  circulation,  exhalation,  and  secretion. 

The  two  functions  of  organic  life  differ,  however,  from  those  of  animal 
life,  in  not  observing,  on  all  occasions,  an  equivalence  of  action :  the 
diminution  of  assimilation  does  not  involve  a  corresponding  diminution 
in  excretion;  hence,  follow  emaciation  and  marasmus,  conditions  in 
which,  assimilation  ceasing  in  part,  dis-assimilation  is  exercised  to  the 
usual  extent,  or  near  it.  From  this  sketch,  it  is  seen  that  the  circula- 
tion of  the  blood  is  the  connecting  link  of  the  two  orders  of  functions 
in  organic  life,  as  the  brain  is  the  connecting  link  of  the  two  orders  of 
functions  in  animal  life.  The  blood  is,  therefore,  in  fact,  composed  of 
two  parts  or  descriptions  of  matter :  one  is  recrementitial,  derived  from 
the  aliment,  and  subservient  to  the  renovation  and  growth  of  parts; 


ORGANIC  LIFE.  43 

the  other  is  excrementitial,  derived  from  the  wrecks  of  all  our  organs, 
and  under  the  necessity  of  being  cast  away  as  useless. 

M.  Bichat  thinks  the  division  of  life  into  Animal  and  Organic  fully 
warranted  by  their  differing  much  from  each  other  in  the  exterior  shape 
of  their  respective  organs,  in  their  mode  of  action,  in  the  duration 
of  their  action,  in  the  effeets  of  custom  or  habit  upon  them,  in  their 
relation  to  the  moral  part  of  man,  and  in  their  vital  force. 

One  of  the  most  prominent  differences  in  the  two  lives  is  the  sym- 
metry and  duplicity  of  the  Organs  of  Animal  Life,  and  the  irregularity 
in  shape  of  those  belonging  to  Organic  Life.  The  impression  of  Light 
is  received  by  two  organs  exactly  alike.  Hearing,  Smelling,  Touch- 
ing, are  likewise  performed  by  organs  having  their  congeners  on  the 
opposite  sides  of  the  body ;  and  even  Tasting,  though  apparently  per- 
formed by  one  organ,  has  that  organ  divided  into  two  equal  and  sym- 
metrical parts,  thus  making  it  like  the  other  organs.  The  whole 
exterior  surface  of  the  body  is,  indeed,  manifestly  divided  into  two 
equal  parts,  marked  off  from  each  other  by  the  fissure  in  the  nose,  the 
upper  lip,  the  chin,  the  raphe  of  the  scrotum  and  perineum,  the  spinous 
processes,  and  the  depression  in  the  superior  posterior  part  of  the  neck. 
The  Brain  and  Spinal  Marrow,  as  belonging  to  animal  life,  consist  of 
two  halves,  presenting  corresponding  arrangements  in  the  development 
of  cavities  and  prominences,  and  so  on,  and  in  sending  similar  nerves 
to  the  organs  of  locomotion  and  of  voice. 

The  organs  of  organic  life  are  marked,  on  the  contrary,  by  the 
character  of  striking  dissimilitude  in  their  two  halves,  as  manifested  in 
the  liver,  the  spleen,  the  stomach,  the  intestines,  the  heart,  and  the 
great  vessels  belonging  to  it.  There  are,  however,  some  organs  of 
organic  life  in  which  the  difference  is  less  prominent,  as  the  lungs  of 
the  two  sides,  the  pulmonary  arteries,  the  veins,  the  trachea,  the  kid- 
neys, the  capsulse  renales,  and  the  salivary  glands. 

From  what  has  been  said,  we  are,  perhaps,  prepared  to  admit  with 
M.  Bichat  that  animal  life  is  double;  that  its  phenomena  being  exe- 
duted  after  the  same  manner  on  both  sides  of  the  body,  it  is  very 
possible  for  the  actions  of  one  side  to  be  suspended  or  destroyed  while 
those  of  the  other  go  on.  This,  in  fact,  happens  in  certain  palsies, 
where  the  sensibility  and  motion  of  one  side  are  so  completely  sus- 
pended that  it  resembles  a  vegetable ;  all  relation  with  exterior  objects 
being  cut  off,  and  nothing  but  the  function  of  nutrition  being  preserved; 
whereas  the  other  side  retains  all  its  animal  properties.  For  these 
reasons  Bichat  has  very  quaintly  observed  that  we  have  a  right  life 
and  a  left  life.  In  organic  life,  on  the  contrary,  the  functions  of  the 
two  halves  of  any  organ  are  so  allied,  that  the  lesion  of  one  affects  the 


44  VITAL  FUNCTIONS. 

other.  The  liver,  in  a  disease  on  one  side,  has  its  functions  impaired 
throughout :  it  is  the  same  with  the  intestinal  canal,  and  with  the  heart. 

Congenital  deformities  are  said  to  be  more  frequent  in  the  organs  of 
organic  life  than  in  those  of  animal  life.  Several  cases  have  occurred, 
and  Bichat  relates  one  which  happened  in  his  own  amphitheatre,  wThere 
there  was  a  general  displacement  of  the  digestive,  the  circulatory,  the 
respiratory,  and  the  secretory  viscera.  The  stomach,  the  spleen,  the 
sigmoid  flexure  of  the  colon,  the  point  of  the  heart,  the  aorta,  and  the 
lung  with  two  lobes,  were  all  on  the  right  side.  But  the  liver,  the 
caecum,  the  base  of  the  heart,  the  venae  cavae,  the  vena  azygos,  and 
the  lung  with  three  lobes  were  on  the  left  side.  All  the  organs  placed 
beneath  the  middle  line,  as  the  mediastinum,  the  mesentery,  the  duo- 
denum, the  pancreas,  the  division  of  the  trachea,  were  reversed.  I 
have  had  occasion  to  observe,  in  our  own  dissecting  rooms,  two  cases  of 
the  caput  coli  removed  from  the  right  iliac  into  the  left  iliac  region ; 
the  colon  was  of  the  common  size  and  length,  and  being  confined  to 
the  left  side  of  the  abdomen,  formed  there  a  loop,  which  ascended  into 
the  left  hypochondriac  region,  and  then  descended  as  usual.  In  these 
cases,  as  there  was  no  transverse  mesocolon,  the  duodenum  had  all  the 
coats  of  the  other  intestines ;  and  was  not  attached  to  the  front  of  the 
right  kidney  and  to  the  spine.  One  of  these  was  an  adult  female  sub- 
ject of  considerable  corpulency,  the  other  a  corpulent  male. 

Another  difference  between  organic  and  animal  life  exists  in  the 
mode  of  action  of  their  respective  organs.  Each  of  the  organs  of 
animal  life  being  double,  our  sensations  are  the  more  exact,  as  there 
exists  between  the  two  impressions,  from  which  they  result,  a  more 
perfect  correspondence.  "We  see  badly  when  the  images  transmitted 
to  the  brain  are  derived  through  eyes  of  unequal  strength.  Without 
knowing  this  law  as  theorists,  we  instinctively  show  its  influence  in 
shutting  one  eye  while  looking  through  a  convex  glass ;  whereby  we 
prevent  a  confusion  of  images  arising  from  two  impressions  of  unequal 
force  concerning  the  same  body :  when  one  eye  is  weaker  than  the 
other,  we  squint  involuntarily,  and  it  finally  becomes  a  habit,  in  order 
to  avoid  the  confusion  of  perception  from  two  unequal  images  on  the 
brain.  This  accounts  for  squinting,  both  in  early  life,  from  some  con- 
genital cause,  and  for  that  squinting  which  is  the  result  of  inflamma- 
tion, in  more  advanced  life.  A  little  reflection  on  this  head  will  satisfy 
us  ;  for,  as  a  single  judgment  or  perception  is,  for  the  most  part,  formed 
from  the  two  impressions,  one  on  each  eye,  how  is  it  possible  that  this 
judgment  can  be  accurate,  when  the  same  body  is  presented  at  the 
same  moment  with  vivid  or  faint  colors,  accordingly  as  it  was  painted 
on  the  strong  or  the  weak  eye  ? 

The  ear  is  subjected  to  the  same  law  as  the  eye.     If,  in  the  two  sen- 


ORGANIC  LIFE.  45 

sations  composing  the  act  of  hearing,  one  is  received  upon  an  organ 
better  developed  than  the  other,  and  more  discriminating  in  its  func- 
tions, it  will  leave  an  impression  more  clear  and  distinct ;  but  the  brain, 
being  affected  simultaneously  by  the  unequal  impressions,  will  be  the 
seat  of  an  imperfect  conception.  This  case  constitutes  a  false  ear  in 
music,  and  from  the  impressions  being  continually  confused,  prevents 
the  individuals  from  judging  rightly  between  harmony  and  dissonance. 

A  similar  reasoning  has  been  founded  by  Bichat  upon  the  structure 
of  the  Nose,  Mouth,  and  Organs  of  Touch.  He  believes  also  that  the 
brain  itself,  as  the  seat  of  the  mind,  may  become  the  cause  of  error  in 
our  ideas,  when  the'two  halves  of  it  are  not  perfectly  alike ;  for  exam- 
ple, if  one  of  the  hemispheres  be  more  strongly  organized  than 'the 
other,  betterdejfiloped '  every  where,  and  more  susceptible  of  a  vivid 
impression.  >**  The  brain  transmits  to  the  soul  the  impression  or  impulse 
derived  from^Jte  senses,  as  the  latter  transmit  to  the  brain  their  impres- 
sions ;  it  is,  therefore,  to  be,  believed  that  the  soul  will  perceive  con- 
fusedly, when  the  Jigmispheres,  being  unequal  in  force,  do  not  blend 
into  one  the  double  impression  upon  them.  In  proof  of  this,  it  is 
common  to  see  mental  derangements  depending  on  the  compression  of 
a  hemisphere  by  effused  blood,  by  pus,  by  depressed  bone,  and  by  an 
exostosis  from  the  internal  face  of  the  cranium.  Even  where  every 
sign  of  compression  is  removed,  the  hemisphere  occasionally  takes  a 
long  time  to  regain  its  action,  so  as  to  recover  from  the  alienation. 

This  harmony  of  action  exists  also  in  the  organs  of  locomotion,  and 
of  voice  ;  and  anything  which  interrupts  their  symmetry  destroys  the 
precision  with  which  their  functions  are  executed. 

Opposed  to  this  harmony  in  the  shape  and  functions  of  the  organs 
of  animal  life,  the  most  striking  differences  may  take  place  between 
the  organs  of  organic  life,  without  much  disturbance  in  the  general  result. 
For  example,  in  disparities  of  the  kidneys,  of  th'e  lungs,  of  the  salivary 
glands,  £c.,  their  functions  are  not,  by  any  means,  the  less  perfectly 
performed.  The  circulation  remains  the  same  in  the  midst  of  the 
frequent  varieties  of  the  vascular  system  on  the  two  sides  of  the  body, 
whether  those  varieties  exist  naturally,  or  whether  they  depend  upon 
artificial  obliterations  of  the  large  vessels,  as  in  aneurism. 

Another  very  striking  difference  in  the  two  lives  may  be  observed 
in  the  duration  of  their  action.  All  the  excretions  proceed  uninter- 
ruptedly, though  not  uniformly.  Exhalation  and  absorption  succeed 
each  other  incessantly ;  assimilation  and  disassimilation  follow  the 
same  rule.  On  the  other  hand,  every  organ  of  animal  life,  in  the  ex- 
ercise of  its  functions,  has  alternations  of  activity  and  of  complete 
repose.  The  senses,  fatigued  by  long  application,  are  for  the  time 


46  VITAL  FUNCTIONS. 

disqualified  from  farther  action.  The  Ear  is  no  longer  sensible  of 
sounds :  the  Eye  is  closed  to  light ;  sapid  bodies  no  longer  excite 
the  Tongue ;  the  Nose  is  insensible  to^  odors ;  'and  the^Couch  be- 
comes obtuse.  Fatigued  by  the  continued  exercise  of  perception,  of 
imagination,  and  of  memory,  the  brain  has  to  recruit  its  strength,  by  a 
state  of  complete  inactivity  for  some  time.  The  muscles,  relaxed  by 
fatigue,  are  incapable  of  farther  contraction,  till  they  have  been  per- 
mitted to  rest ;  hence  the  necessary  intermission,  in  every  individual, 
of  locomotion  and  of  voice. 

This  intermission  of  action  is  sometimes  extended  to  all  the  organs 
of  animal  life  at  the  same  time  ;  onVothe/  <\ccaliias,7m*l1^a  part  of 
them  is  affected  by  it.  It  is  in  this  way  that  tlieNbram  frequently  con- 
tinues in  the  active  exercise  of  thought,  •ykiiilc*4]^  senses,  as  well  as 
the  powers  of  locomotion  and  of  voice, Aar^uspe*lff& 

•^  >  > 

In  addition  to  the  foregoing  viewsi^kj^is  also  beeSAyjggested  by 
Bichat,  that  another  striking  difference  beti^enjWganic  and  animal 
life  is  found  in  the  epoch  and  mode*  of  their  "Origin.  Organic  life 
exists  from  the  first  moments  of  conceptro^T ;\v  butJfnuai^life  does  not 
commence  till  after  birth,  when  exterior  objecta-|jre  established  in  a 
certain  relation  with  the  individual.  It  is  morp  than*  probable  that 
the  functions  of  the  Eye,  the  Ear,  the  Tongue,  and  the  Nose,  do  not 
exist  in  such  manner  as  to  communicate  their  several'^n^ations  in  the 
foetus  ;  and  that  the  enjoyment  of  a  sort  of 'indistinct  sense  of  touch, 
arising  from  its  striking  against  the  parietes  of  the  womb,  is  the  only 
circumstance  which  can  give  the  latter  any  idea  of-  its  existence ;  it  is, 
however,  doubtful  whether  it  has  even  a  consciousness  on  t^at  point. 
The  organic  life,  on  the  contrary,  of  a  foetus,  though  not  so  complicated 
as  afterwards,  is  still  remarkable  for  the  promptitude  and^vigor  of  some 
of  its  functions,  particularly  of  assimilation  ;  and  in  a  very  short  time 
after  birth,  all  the  organs  which  it  employs  reach  their  highest  degree 
of  perfection,  and  thus  present  a  very  different  case  from  .the  organs  of 
animal  life. 

The  distinction  of  the  two  lives  is  farther  ke^up  in  t^gir  manner 
of  ceasing  in  old  age.  Natural  death,  says  Bic»at,  is  rema'rkable  in 
terminating  animal  life,  almost  entirely,  a  long  time  "before  it  does 
organic  life.  The  functions  of  the  first  cetise  successively.  The  Sight 
becomes  dim,  confused,  and  is  finally  extinguished,  l&e  Ear  receives 
the  impression  of  sounds  indistinctly,  then  faintly,  and^afterwards  they 
are  entirely  lost  upon  it.  The  Skin  becomes  shrivelled,  hardened,  loses 
many  of  its  vessels,  by  their  obliteration ;  and  is  only  the  seat  of  an 
obscure  and  indistinct  touch ;  the  hair  and  beard  become  white, 
and  fall  from  it.  The  Nose  loses  its  sensibility  to  odors.  Of  all  the 


ANIMAL  LIFE.  47 

senses,  it  has  been  often  remarked,  that  the  Taste  remains  the  longest, 
and  exhibits  the  last  efforts  of  animal  life. 

The  powers  of  the  mind  disappear  along  with  those  of  the  senses. 
The  imagination  and  the  memory  are  extinguished ;  the  latter,  however, 
under  striking  circumstances.  The  old  man  forgets,  in  an  instant,  what 
was  said  to  him,  because  his  external  senses,  being  weakened,  do  not 
confirm  sufficiently  the  impression  on  his  mind:  he  is,  however,  able  to 
recollect  the  transactions  of  early  life,  and  sometimes  retains  a  vivid 
impression  of  them.  He  differs  from  the  infant  in  this,  that  the  latter 
forms  his  judgments  from  what  is  passing,  whereas  the  former  forms 
his  from  what  has  already  past.  Both  are,  therefore,  liable  to  great 
errors;  for,  the  accuracy  of  knowledge,  in  regard  to  things  present, 
can  only  be  obtained  by  comparing  them  rigidly  with  other  things. 
Locomotion  and  voice  also  participate  in  the  decline  of  the  other  organs 
of  animal  life ;  their  powers  are  intrinsically  weakened ;  besides  which, 
a  certain  degree  of  inactivity  is  imposed  on  them  by  the  previous  de- 
cline of  the  brain  and  senses. 

If  we  now  consider  that  sleep  retrenches  about  one-third  of  the 
whole  duration  of  animal  life ;  that  nine  months  of  it  are  first  lost  in 
gestation ;  and  that  the  extinction  of  our  senses  is  the  inheritance  of 
old  age ;  it  will  be  seen  how  great  is  the  difference  between  the  whole 
duration  of  animal,  and  of  organic  life. 

It  has  been  remarked  by  Bichat,  that  the  idea  of  death  is  painful  to 
us  only  because  it  terminates  our  animal  life,  or  those  functions  which 
put  us  in  relation  with  surrounding  objects.  This  is  the  privation  which 
plants  terror  and  dismay  on  the  borders  of  the  tomb.  It  is  not  the 
pain  of  death  that  we  fear,  for  many  dying  persons  would  willingly 
commute  death  for  an  uninterrupted  series  of  bodily  suffering.  But  if 
it  were  possible  for  a  man  to  epdst  whose  death  would  only  affect  the 
functions  of  organic  life,  as  the  circulation,  digestion,  and  secretions, 
allowing  the  exercise  of  the  senses  and  the  mind  to  continue,  this  man 
would  view  with  indifference  the  extinction  of  organic  life ;  because  he 
knows  that  the  happiness  of  living  is  not  attached  to  it,  and  that  he 
would  remain,  after  this  partial  death,  still  in  a  condition  to  appreciate 
all  the  delightful  ties  of  existence.1 

1  For  a  detailed  exposition  of  the  phenomena  of  the  Animal  and  of  the  Organic  Functions, 
see  Human  Physiology,  by  Robley  Dunglison,  M.  D.,  Professor,  &c.,  Jefferson  College.  Prin- 
ciples of  Human  Physiology,  by  W.  B.  Carpenter,  M.  D.  Elements  of  Physiology,  by  ditto  ; 
Phila.  edition.  And  Elements  of  Physiology,  by  J.  Muller,  M.D.,  translated  from  the  German 
by  W.  Baly,  M.  D.,  London,  1840;  also  the  Philadelphia  edition  of  the  same,  arranged  by 
John  Bell,  M.  D.,  1843. 


CHEMICAL    COMPOSITION. 


CHAPTER  II. 

UPON  the  death  of  the  body,  the  liquids  and  tissues  which  compose 
it  are,  when  submitted  to  decomposition  by  chemical  process,  found  to 
consist  of  a  number  of  elementary  ingredients  which  are  common  to  it 
and  to  inorganic  bodies,  and  amount  to  about  twenty. 

These  Chemical  Elements,  as  ascertained  up  to  the  present  day  to 
exist  in  a  state  of  health,  are,  oxygen,  hydrogen,  nitrogen,  carbon, 
phosphorus,  chlorine,  sulphur,  fluorine,  potassium,  sodium,  calcium, 
magnesium,  silicium,  aluminium,  iron,  manganese,  titanium,  lead,  and 
copper  :  also  iodine  and  bromine,  which  are  almost  exclusively  from 
marine  plants  and  animals.  The  oxygen,  hydrogen,  nitrogen,  carbon, 
and  phosphorus  of  themselves  make  the  principal  mass  of  the  solids 
and  liquids.  The  calcium  is  found  in  great  quantities  in  the  bones  in 
combination  with  phosphoric  and  carbonic  acids  ;  the  other  elements 
exist  in  much  smaller  proportions,  there  being  but  little  more  than  a 
trace  of  them  found  upon  the  decomposition  of  any  part.  The  metals 
and  the  metalloids  are  not  in  their  pure  state,  but  united  to  chlorine  or 
in  that  of  oxide  combined  with  carbonic,  phosphoric,  or  sulphuric  acid. 
They  may  be  detected  in  the  ashes  of  most  animal  substances.  The 
iron  is  considered  generally  as  an  essential  ingredient  in  hematosin  or 
the  coloring  principle  of  the  blood,  and  in  the  pigmentum  nigrum  ;  it 
has  been  found  also  in  the  lens  and  in  the  hairs.  The  existence  of  arsenic 
was  asserted  by  Raspail  and  Orfila,  who  considered  it  to  be  introduced 
in  phosphoric  aliments,  which  always  contain  a  small  quantity  of  it. 
This  unexpected  declaration,  which  must  of  course  have  a  most  im- 
portant legal  bearing  in  cases  of  imputed  poisoning,  has  been  contested 
by  Flandin  and  Danger,  who  declare  that  what  Raspail  and  Orfila 
consider  as  arsenical  stains  in  their  experiments,  are  equally  produced 
by  sulphate  and  phosphate  of  ammonia  united  to  an  animal  substance. 

The  most  diffused   chemical   elements   are   the   oxygen,  hydrogen, 


CHEMICAL  COMPOSITION.  49 

nitrogen,  and  carbon  :  they  are  the  most  essential  principles  of  organic 
matter,  as  two  of  them  at  least  must  be  present  in  every  such  com- 
pound. The  other  inorganic  substances  are  found  in  much  smaller 
proportion,  and  seem  to  be  merely  incidental  to  animal  organism  so  as 
to  make  out  some  physical  condition,  probably  not  absolutely  essential 
to  life.  Among  these  the  phosphate  of  lime  holds  a  high  rank  from  its 
making  about  fifty  per  cent,  of  the  skeleton,  and  next  to  it  is  the  car- 
bonate of  lime  from  its  making  about  eleven  or  twelve  per  cent,  of  the 
same.  The  other  incidental  articles  are  found  in  very  small  fractional 
quantities,  and  appear  more  as  matters  of  curiosity,  than  as  striking 
contributions.  The  existence  of  some  is  even  contested. 

Between  the  above  organized  matters  and  the  fully  formed  texture, 
there  is  an  intermediate  condition  resulting  from  their  combination  into 
a  series  of  organic  compounds,  called  proximate  principles  or  organiza- 
ble  substances.  These  exist  in  the  Embryo,  and  are  also  obtained  in 
the  first  stages  of  chemical  analysis.  The  most  abundant  of  them  are 
Protein,  Albumen,  Fibrin,  Casein,  and  Colla  or  Gelatin ;  but  there' 
are  many  others  in  comparatively  small  quantities,  the  traits  of  which 
will  be  presented  in  place. 

The  manner  of  combination  of  the  simple  chemical  elements  to  form 
the  above  organic  compounds,  is  not  yet  settled  by  Chemists.  Some 
consider  them  as  equally  united,  and  view  the  organic  compounds  as 
ternary  or  quaternary  in  degree ;  others  hold  that  two  or  three  of  the 
elements  form  a  compound  radical,  to  which  is  united  another  so  as  to 
form  a  binary  compound.  The  idea  may  be  illustrated  from  inorganic 
Chemistry.  Ether  is  formed  by  four  atoms  of  carbon,  five  of  hydrogen, 
and  one  of  oxygen,  the  first  two  make  a  hypothetical  radical  called 
Ethyl,  to  which  is  united  the  one  atom  of  oxygen ;  ether  is  thus  an 
oxide  of  Ethyl,  and  the  formula  of  its  composition  is  Carbon,  4 ;  Hydro- 
gen, 5;  +  Oxygen,  1. 

In  organic  substances,  it  is  to  be  remarked  that  a  union  limited  to 
two  simple  chemical  elements  is  very  rare,  the  almost  universal  rule 
being  a  compound  radical  of  two  or  more  substances  united  to  an  addi- 
tional one.  These  organized  unions  of  chemical  elements  are  remark- 
able, too,  for  the  facility  of  their  dissolution,  both  during  the  living  and 
the  dead  state. 

Such  obscurity  prevails,  however,  on  the  real  nature  or  condition  of 
these  organic  combinations  of  chemical  elements,  that  their  reproduc- 
tion in  the  laboratory  by  means  purely  scientific  has  scarcely  advanced 
at  all.  The  examples  at  present  are  limited  to  the  formation  by  Wohler 
of  urea,  from  the  cyanate  of  ammonia,  in  depriving  it  of  a  little  ammonia 
by  the  influence  of  heat ; — to  allantoin,  which  is  analogous  to  urea ; — 
and  to  formic  acid,  which  has  likewise  been  elaborated  by  chemistry  alone. 
VOL.  i. — 4 


50  CHEMICAL  COMPOSITION. 

The  organic  compounds  of  animals  are  found  to  a  large  extent  also 
in  vegetables.  The  first  elaboration  from  the  inorganic  state  occurring 
in  the  lattej  renders  them,  therefore,  highly  suitable  as  food  for  man, 
the  transition  or  modification  being  an  inconsiderable  one  from  the 
vegetable  to  the  animal  condition.  The  blood  is  the  grand  reservoir 
for  the  introduction  and  distribution  of  these  organic  compounds,  each 
of  which  has  its  utility,  so  that  neither  albumen,  gelatin,  casein,  nor 
fibrin  alone  will  sustain  life. 

Of  substances,  the  result  of  organization  and  of  a  character  essen- 
tial to  it  is  Protein,  which  is  the  base  of  all  albuminous  bodies  both  in 
the  animal  and  vegetable  kingdom.  It  exists  in  fact  in  every  tissue  of 
the  animal  and  of  the  vegetable  fabric,  being  found  dissolved  in  their 
fluids  and  condensed  in  their  solids.  It  may  be  obtained  by  dissolving 
boiled  albumen  in  a  weak  solution  of  caustic  alkali,  and  then  precipitat- 
ing by  the  addition  of  an  acid.  The  protein  thus  treated  falls  under 
the  form  of  grayish-white  flakes.  When  starch  is  washed  from  wheat 
flour,  so  as  to  leave  merely  the  gluten,  the  latter  treated  by  the  above 
process  yields  also  protein.  The  protein  obtained  in  both  cases  appears 
to  be  identical  in  its  sensible  and  in  its  chemical  properties ;  it  is  also 
made  soluble  by  an  alkali  and  precipitated  by  an  acid.  It  is  hence  seen 
that  the  transition  from  the  vegetable  to  the  animal  form  of  matter  is 
one  of  comparative  simplicity.  Protein  is  found  abundantly  in  albu- 
men, fibrin,  casein,  &c.,  united  to  a  small  quantity  of  sulphur,  of  phos- 
phorus, or  of  salts,  from  which  it  is  easily  freed  by  certain  chemical 
processes,  the  formulae  for  which  may  be  readily  found.1  In  a  humid  state, 
this  substance  is  gelatinous,  insipid,  inodorous.  It  is  insoluble  in  water, 
alcohol,  or  ether.  When  dried,  it  is  brown,  hard,  and  fragile.  When 
pulverized,  it '  makes  a  yellow,  amber-colored  powder.  It  attracts 
moisture  from  the  air,  and  when  placed  in  water,  swells  up  and  resumes 
its  first  condition.  On  chemical  analysis,  it  is  found  to  be  composed,  in 
a  hundred  parts,  of  nitrogen  16.01,  carbon  55.29,  hydrogen  7,  oxygen 
21.70. 

Albumen  is  the  most  universal  of  the  modifications  of  protein.  A 
striking  example  of  it  is  the  white  of  an  egg,  where  it  is  collected  into 
a  large  agglomerated  mass,  but  it  is  also  found  in  the  serum  of  the 
chyle,  of  the  lymph,  and  of  the  blood,  in  the  serosity  of  serous  cavities, 
in  pus,  in  pathological  secretions,  and  in  the  greater  part  of  the  liquids 
secreted  from  the  blood.  Whatever  tissue  one  examines,  a  proportion 

1  See  Henle. — Encyclop.  Anat.  vol.  vi. — Simon's  Animal  Chemistry,  Philad.  edition, 
1846. 


FIBRIN — CASEIN.  51 

of  albumen  is  always  found  in  it,  and  it  is  also  one  of  the  constituent 
principles  of  the  brain  and  of  the  nerves.  Its  natural  state  is  one  of 
fluidity,  but  it  is  easily  evaporated  to  dryness,  and  then  forms  a  bril- 
liant transparent  mass  of  a  yellowish  color.  It  is  rendered  firm  or 
coagulated  by  heat,  most  of  the  acids,  and  by  many  of  the  neutral  salts. 
Its  natural  disposition  is  to  remain  fluid  or  semi-fluid ;  it  is  only  when 
under  chemical  influences  that  it  solidifies.  It  is  so  nearly  allied  to 
protein,  that,  according  to  Mulder,  it  differs  from  it  only  by  a  very 
small  introduction  of  phosphorus  and  of  sulphur  into  it,  both  together 
making  but  one  part  in  a  hundred. 

Fibrin,  another  of  the  modifications  of  protein,  is  also  found  in  the 
blood,  the  lymph,  the  chyle,  the  serosity  of  serous  cavities,  and  is  re- 
markable for  the  quantity  which  is  thrown  out  upon  inflamed  surfaces 
and  in  inflamed  tissues.  It  constitutes  the  base  of  the  muscular  system. 

It  resembles  exactly  in  appearance  albumen,  and  the  principal  charac- 
teristic distinction  from  it  is  that  of  coagulating  spontaneously.  The 
blood  of  asphyxiated  persons,  of  animals  dead  from  fatigue,  of  certain 
poisoned  individuals,  and  of  such  as  die  of  hemorrhage  from  trivial 
wounds,  does  not  coagulate.  It  is  hence  inferred  that,  in  such  cases, 
the  fibrin  does  not  exist,  for  by  some  vital  process  it  has  disappeared. 

Under  chemical  analysis,  it  seems  to  be  almost  the  same  with  albumen ; 
in  Mulder's  experiments,  it  contained  a  little  more  sulphur,  with  a 
trifling  variation  in  the  quantity  of  the  other  ingredients.  It  contracts 
with  acids,  neutral  salts,  and  different  bases,  the  same  combinations 
with  albumen.  The  most  remarkable  chemical  difference  between  the 
two  is  their  habit  in  regard  to  oxygenated  water.  Chlorohydric  acid 
makes  a  violet  color  with  albumen — tand  an  indigo  blue  with  fibrin. 

Casein,  another  of  the  products  of  protein,  is  found  principally  in 
milk,  but  is  not  confined  to  it,  as  it  exists  also  in  the  blood,  the  saliva, 
the  bile,  the  pancreatic  juice,  in  pus,  in  tuberculous  matter,  and  else- 
where, also  in  vegetables. 

There  are  several  processes  known  to  Chemistry  for  obtaining  casein. 
One  of  the  most  simple  is  that  of  Mulder,  who  adds  acetic  acid  to  milk, 
whereby  the  casein  is  precipitated,  washes  the  precipitate  in  pure  water 
repeatedly,  squeezes  the  water  out  on  each  occasion,  and  afterwards 
removes  the  grease  with  boiling  alcohol. 

Dissolved  in  water,  casein  is  of  a  pale  yellow  and  of  a  consistence 
somewhat  mucilaginous.  On  being  evaporated,  it  exhales  the  odor  of 
milk,  and  covers  itself  with  a  white  pellicle  which  upon  being  removed 
is  renewed.  On  being  perfectly  dried,  it  forms  a  mass  of  a  yellow  am- 
ber color,  easily  reduced  to  powder,  and  which  attracts  the  moisture  of 


52  CHEMICAL  COMPOSITION. 

the  atmosphere.  In  the  humid  or  dissolved  state,  the  addition  of 
alcohol  makes  it  opaque,  and  to  resemble  coagulated  albumen,  this  is 
produced  by  the  abstraction  of  its  water.  It  is  soluble  to  a  small 
extent  in  boiling  alcohol,  and  from  that  state  of  solution  it  may  be 
extracted  without  any  change  of  its  properties. 

The  analogy  of  casein  with  albumen  and  fibrin  is  very  close  in  many 
respects,  and  especially  in  regard  to  its  power  of  coagulation,  or  capa- 
city to  change  its  state,  so  that  it  is  no  longer  soluble  in  water. 

Casein  is  coagulated  by  heat,  by  alcohol,  by  acids,  and  by  rennet  or 
the  stomach  of  young  animals.  In  boiled  milk,  the  skin  or  pellicle 
which  forms  upon  its  surface  is  coagulated  cheese.  Alcohol  precipi- 
tates it  by  abstracting  the  water  which  held  it  in  solution.  Many  of 
the  acids  coagulate  it  freely,  and  notably  the  lactic  acid  which  is  pro- 
duced from  the  sugar  of  milk,  when  the  milk  sours.  Sugar  of  lead  is  a 
powerful  coagulator  of  the  same.  The  modus  agendi  of  rennet  or  the 
dried  stomach  of  young  animals,  in  coagulating  casein  or  milk,  is  as 
yet  inexplicable.  Its  influence,  however,  in  this  respect  is  truly  re- 
markable. Berzelius  coagulated  1800  parts  of  milk  with  only  one  of 
rennet,  and  found  that  the  latter  had  lost  only  six  per  cent,  of  its 
weight.  It  is  ascertained  by  experiment  that  pure  casein  dissolved  in 
water  is  not  coagulated  by  rennet,  but  as  the  latter  has  that  power 
upon  casein  dissolved  in  milk,  it  is  hence  suggested  by  Henle1  as  pos- 
sible that  the  rennet  only  acts  indirectly  by  the  conversion  of  the 
sugar  of  milk  into  lactic  acid. 

Cheese  which  is  prepared  by  rennet  alone  is  called  sweet  cheese, 
and  when  prepared  by  lactic  acid  it  is  called  acid  cheese.  It  is  sup- 
posed that  it  exists  to  a  limited  extent  already  coagulated  in  fresh 
milk,  inasmuch  as  the  envelopes  of  the  globules  of  milk  appear  under 
the  microscope  to  be  insoluble  casein. 

Common  cheese  is  a  composition  of  dried  casein  and  of  butter. 
Pure  casein,  according  to  Mulder,  contains  in  one  hundred  grains 
nitrogen  15.95 ;  carbon  55.10 ;  hydrogen  6.97  ;  oxygen  21.62,  and 
sulphur  0.36.  Casein  contains  a  quantity  of  phosphate  of  lime 
amounting  indeed  to  6T~04g  per  cent.,  the  presence  of  which  is  of  the 
greatest  importance  for  the  nutrition  of  infants  and  for  the  formation 
of  bone. 

Pepsin  is  another  combination  of  protein,  and  was  discovered  by 
Schwann  in  1836.  It  is  formed  and  found  in  the  cells  of  the  follicles 
and  of  the  solid  glands  of  the  stomach,  and  may  be  obtained  by  mace- 
rating the  mucous  membrane  of  the  stomach  of  an  animal  in  distilled 

1  Henle,  loc.  cit.  p.  46. 


GLOBULIN — SPERMATIN.  53 

water.  A  solution  thus  made  may  be  precipitated  by  basic  acetate  of 
lead,  and  afterwards  separated  from  the  lead  by  a  particular  process. 
This  pepsin,  when  largely  diluted  with  water  and  mixed  with  a  small 
quantity  of  acid,  constitutes  an  artificial  gastric  juice  which  dissolves 
albumen  in  six  or  eight  hours  ;  it  has  the  same  effect  upon  cartilage 
and  upon  cellular  substance.  It  resembles  very  much  albumen,  but, 
unlike  it,  cannot  be  precipitated  from  its  combinations  with  acids  by 
the  ferrocyanate  of  potash. 

There  are  some  substances  in  the  composition  of  the  body  which, 
according  to  Professor  Henle,  ought  not  to  be  considered  as  belonging 
to  its  immediate  materials.  They  are  Globulin,  Spermatin,  Mucus, 
Dacryolin  or  the  matter  of  the  Tears ;  and  the  Horn-like  productions. 

Globulin.  This  material  exists  in  the  blood,  and  is  the  name  given 
by  Berzelius  to  a  residuum  of  it  obtained  in  a  particular  way.  By 
diluting  with  water  the  red  globules  of  the  blood,  they  become  trans- 
parent, swell  up,  and  at  last  disappear,  seeming  to  have  been  dissolved  ; 
but  they  may  in  fact  be  brought  into  view  again  by  Iodine,  which 
renders  them  opaque,  thereby  showing  that  the  coloring  matter  may 
be  extracted  by  water,  and  still  leave  the  globules  behind.  By  evapo- 
rating to  dryness  blood  diluted  with  water,  if  alcohol  be  added,  the 
coloring  matter  will  be  taken  up  by  the  alcohol,  and  the  globules  will 
be  left ;  this  residuum  then  is  the  globulin  of  Berzelius,  and  the  color- 
ing matter  dissolved  by  the  alcohol  is  the  hasmatosin. 

Globulin,  upon  trial  by  chemical  analysis,  is  almost  identical  with 
albumen,  and  seems  to  be  such  in  reality ;  it  is,  therefore,  upon  good 
grounds  placed  by  Mulder  among  the  combinations  of  protein.  It  is 
formed  by  the  capsule  of  the  blood-disks,  with  perhaps  the  nuclei. 
When  extracted,  according  to  the  process  of  Lecanu,  with  sulphuric 
acid,  its  y  analysis  furnishes  the  following  parts:  nitrogen  15.70;  car- 
bon 54.11 ;  hydrogen  7. IT  ;  oxygen  20.52  ;  sulphuric  acid  2.50,  which 
corresponds  nearly  with  four  atoms  of  protein  to  one  of  anhydrous 
acid. 

Spermatin  is  a  fluid  derived  from  the  semen  of  animals.  At  the 
moment  of  obtaining  the  semen  in  a  fresh  state,  it  is  placed  in  alcohol, 
upon  which  it  contracts  in  a  few  minutes  an  opaline  color,  and  forms  a 
clot  like  a  pack  thread,  collected  into  a  small  bundle  or  hank.  It  may 
be  dried  in  this  state,  when  it  forms  a  bunch  of  filaments  of  the  color 
of  snow.  The  article  thus  coagulated  constitutes  the  spermatin  of 
Berzelius,  of  Yauquelin,  and  of  John,  by  the  last  two  of  whom  it  was 
discovered.  It  may  be  identified  by  Certain  characters  or  habitudes  in 
regard  to  water,  mentioned  by  Berzelius. 


54  CHEMICAL  COMPOSITION. 

This  fluid  shows,  under  the  influence  of  chemical  agents,  a  close 
analogy  with  albumen.  An  analysis  of  it,  however,  must,  to  a  large 
degree,  be  inconclusive,  as  the  seminal  fluid  from'  which  it  is  obtained 
is  a  mixture  of  the  secretion  of  the  testicles,  of  the  vesiculae  seminales, 
of  the  prostate,  of  the  glands  of  Cowper  and  of  the  urethra,  besides 
containing  scales  of  epithelium,  corpuscles  of  mucus,  and  spermatic 
animalcules. 

Mucus.  Heretofore  everything  has  been  considered  mucus  which 
came  from  the  surface  of  a  mucous  membrane  excepting  certain  secre- 
tions of  a  decidedly  specific  character,  as  the  saliva,  the  bile,  the  urine, 
and  a  few  more.  It  is  now,  however,  ascertained  that,  in  the  fluid 
commonly  called  mucus,  there  are  at  least  three  dissimilar  constituents, 
to  wit : — the  waste  of  the  epidermic  mucous  membrane,  pus,  and  the 
mucous  secretion  itself. 

The  epidermic  waste,  or  molt,  resembles  the  scaly  exfoliation  which 
is  incessantly  in  progress  from  the  cuticle ;  and  is  formed  by  the  des- 
quamation  of  the  superior  layers,  which,  as  they  fall  off,  are  succeeded 
by  others.  These  scales  are  washed  off  by  the  fluid  secretions  of  the 
part,  and  make  to  the  mucous  membrane  a  glairy  coating,  which  is 
easily  removed  by  scraping  and  by  a  stream  of  water.  The  pus  is 
found  in  catarrh,  coryza,  blennorrhagia,  fluor  albus,  and  diarrhoea; 
and  is  formed  from  a  liquid  mixed  with  granules  of  a  certain  kind, 
coming  from  beneath  the  Epidermis  of  the  mucous  membranes.  The 
mucous  secretion  is  the  product  of  the  muciparous  g\ands,  and  is  for 
the  mucous  membranes  what  the  perspiration  is  for  the  skin.  It  also 
is  considered  to  be  elaborated  by  the  epithelial  cells  of  mucous  mem- 
branes, which  in  this  process  are  constantly  liquefying  or  bursting 
open. 

Mucus  from  the  nose,  according  to  the  analysis  of  Berzelius, 

consists  in  Mucin  essentially          .  .  .  .5.33 

An  extract  soluble  in  alcohol  and  an  alkaline  lactate  V         0.30 

Chloride  of  Soda  and  of  Potash        .  .  :  .          0.56 

An  extract  soluble  in  water,  with  traces  of  albumen  and  of  a 

phosphate  .  .  .  .  .  .0.35 

Soda  ......  v^      0.09 

Water  93.37 


100.00 


Lachrymal  Matter  or  Dacryolin.     This  is  found  as  a  residuum  upon 
the  evaporation  of  the  tears  in  the  open  air.     In  this  condition,  it  forms 


EXTRACTIFORM  SUBSTANCES.  55 

a  yellow  and  insoluble  mucus,  which  neither  heat  nor  acids  coagulate. 
Fourcroy  and  Vauquelin  find  in  it  one  per  cent,  of  a  solid  substance 
seeming  to  be  chloride  of  soda  principally ;  and  the  remainder  of  this 
one  per  cent,  is  probably  mucus  and  the  scaly  molt  of  the  epithelium. 

The  Horn-like  tissues,  made  of  Keratin,  are  represented  by  the 
nails,  the  hair,  and  the  epidermis.  It  was  once  supposed  that  they 
were  formed  from  a  fluid  which  dried  up,  but  it  is  now  known  that  in 
the  case  of  each  one,  the  primordial  state  is  that  of  a  cell,  with  a  con- 
tained substance  and  a  nucleus ;  and  that  it  is  an  aggregation  of  such 
cells  in  a  collapsed  state,  but  adhering  to  one  another,  which  constitutes 
the  substances  above  alluded  to. 

The  cells  or  scales  of  the  epidermis  are  held  together  by  an  inter- 
mediate substance  which  dissolves  in  weak  acids,  and  allows  the  scales 
to  separate  and  float  about,  giving  to  them  the  fallacious  appearance  of 
being  dissolved  also. 

Extractiform  Substances. 

After  removal  of  the  combinations  of  protein  from  animal  matter,  a 
nitrogenous  organic  residuum  still  remains  mixed  up  with  certain  salts 
as  lactates,  chlorides,  phosphates,  and  sulphates.  What  remains  upon 
the  separation  of  the  salts  by  their  appropriate  solvents  constitutes  the 
Extractive  Matter.  Animal  Extractive  is  very  generally  diffused  in 
the  tissues  and  humors  of  the  body,  but  is  found  in  greater  abundance 
than  elsewhere  in  the  muscular  flesh.  This  matter  is  readily  obtained 
by  steeping  a  part  in  aqueous  alcohol,  and  then  evaporating  the  latter 
entirely.  If  pure  alcohol  be  poured  upon  this  dry  residuum,  it  removes 
from  it  a  substance  called  the  alcoholic  extract,  and  what  is  left  con- 
stitutes the  aqueous  extract,  being  soluble  alone  in  water,  and  consti- 
tuting what  Thenard  has  called  Osmazome  (from  Oa^  smell,  and  £0^0$ 
soup) ;  it  is  found  abundantly  in  soups  or  bouillons,  and  in  them  is  mixed 
with  gelatin  in  the  proportion  of  one  part  to  seven  of  gelatin.  It  is 
the  osmazome  which  gives  flavor  specifically  to  soups  and  meats.  The 
extractive  matter  presents  itself  in  several  soluble  forms;  one,  the 
water  extract,  is  soluble  in  water  but  not  in  dilute  alcohol ;  another  is 
soluble  in  dilute  but  not  in  anhydrous  alcohol ;  it  is  the  spirit  extract : 
a  third,  the  alcoholic  extract,  is  soluble  in  water,  in  dilute  alcohol,  and  in 
anhydrous  alcohol. 

The  extractiform  substances  show  themselves  under  several  modifi- 
cations when  tried  by  chemical  tests ;  the  processes  whereby  they  may 
be  detected  are  set  forth  in  the  works  on  organic  chemistry.1  One  is 


; 


1  See  Henle.     Also  Simon,  on  Animal  Chemistry. 


56  CHEMICAL  COMPOSITION. 

called  Ptyalin,  from  its  being  found  in  the  salivary  secretion ;  another 
Kreatin,  from  its  being  found  in  the  liquids  of  meat.  There  are  also 
several  others  which  may  be  distinguished  by  different  chemical 
agents. 

Grlne,  or  Oolla. 

Glue  may  be  obtained  from  many  animal  tissues,  but  never  exists  in 
them  in  that  state,  and  is  produced  by  boiling  them  in  water.  The 
substances  most  productive  of  it  are  bones,  cartilages,  tendons,  cellu- 
lar tissue,  and  ligamentous  matter.  The  tendons  and  true  ligaments 
are  so  prone  to  this  transformation,  that  they  yield  a  weight  of  glue 
equal  to  their  own  weight,  both  being  dry. 

In  the  process  of  producing  glue  by  the  action  of  boiling  water,  there 
is  neither  a  disengagement  of  gas  nor  an  absorption  of  any  of  the  con- 
stituents of  the  atmosphere.  Acids,  much  diluted,  favor  the  process. 
The  substances  which  yield  glue  in  the  fully  organized  body,  if  treated 
in  the  same  way  during  the  earlier  periods  of  development,  produce 
what  is  called  Pyin,  a  matter  differing  from  glue.  The  common  cha- 
racters of  glue  are  so  well  known  as  not  to  require  a  description  on  the 
present  occasion  :  its  chemical  analysis,  according  to  Mulder,  yields,  in 
one  hundred  parts,  nitrogen  18.350;  carbon  50.048;  hydrogen  6.477, 
and  oxygen  25.125.  It  has  also  a  very  small  quantity  of  phosphate 
of  lime  in  it. 

Chondrin. 

Chondrin  resembles  in  many  respects  glue,  and  was  first  discovered 
and  designated  by  J.  Muller.1  It  is  obtained  by  boiling  in  water  the 
cartilaginous  rudiments  of  bones,  the  articular  cartilages,  the  fibro- 
cartilages  of  the  nose,  ear,  larynx,  trachea,  and  some  other  parts,  as 
the  cartilages  of  the  ribs.  It  requires  a  more  protracted  boiling  than 
common  glue  to  produce  it,  and  is  the  base  of  the  permanent  cartilages. 
It  is  precipitated  from  solution  by  alum,  sulphate  of  alumina,  acetic 
acid,  and  acetate  of  lead.  Mulder's  analysis  showed  in  its  composition 
nitrogen  14.44;  carbon  49.56;  hydrogen  6.63;  oxygen  28. 59;  sulphur 
0.38.  Like  glue,  it  contains  about  6  per  cent,  of  inorganic  matter, 
chiefly  phosphate  of  lime. 

Pyin. 

Pyin,  discovered  by  Gueterbock,  in  pus,  whence  its  name,  is  found 
also  elsewhere,  as  in  mucus,  in  tuberculous  matter,  in  granulations,  in 

1  Elem.  Physiol.  vol.  i.  p.  390. 


57 

false  membranes  of  a  recent  date,  in  the  skin  of  a  foetus,  in  condylo- 
matous  productions,  and,  in  fine,  wherever  there  is  a  cellular  substance 
imperfectly  developed.  It  is  obtained  by  adding  alcohol  to  pus,  which 
precipitates  the  pyin  with  albumen ;  it  may  then  be  separated  from  the 
latter  by  water.  The  principal  test  for  it  is  alum,  which  precipitates 
it  in  flocculi  from  a  state  of  solution. 


Hsematin,  or  Hsematosin. 

Haematin  is  the  coloring  matter  of  the  blood,  and  is  found  in  the 
blood-disks  or  globules,  though,  under  certain  circumstances,  it  is  free 
in  the  liquor  sanguinis  or  the  fluid  part.  It  is  thought  that,  in  some 
certain  states  of  the  blood,  the  blood-disks  being  formed  as  they  are 
of  a  vesicular  envelop  and  a  contained  fluid,  when  the  liquor  sanguinis 
is  too  much  inspissated  some  of  the  fluid  of  the  blood-disks  leaves  them 
by  exosmosis  and  joins  the  liquor  sanguinis,  the  vesicle  becoming  some- 
what collapsed;  and  on  the  contrary,  if  the  liquor  sanguinis  be  too 
fluid,  the  vesicles  absorb  some  of  this  fluid  and  become  turgescent. 
While  in  the  former  process,  the  solid  constituent  of  the  blood-disks,  as 
the  hsematin,  passes  outwardly  and  may  become  mixed  with  the  liquor 
sanguinis. 

Pure  hsematin  may  be  obtained  by  several  proceedings  known  to  the 
operative  chemist,  as  through  the  reaction  of  alcohol,  of  ether,  and  of 
sulphuric  acid.  According  to  Muller,  its  chemical  composition,  in  one 
hundred  parts,  is  nitrogen  10.54;  carbon  66:9;  hydrogen  5.30;  oxygen 
11.01;  iron  6.66.  In  a  dried  state,  it  has  a  dark-brown  color,  with  a 
few  brilliant  points,  and  it  is  insipid  and  inodorous. 


Bile. 

This  secretion  is  formed  by  a  resin,  according  to  Thenard,  of  a  green 
color,  not  very  soluble  in  water  and  completely  soluble  in  alcohol.  It 
also  contains  Picromel,1  or  a  biliary  sugar.  This  is  colorless  and 
inodorous,  has  a  sweet  taste  which  endures  for  some  time  in  the  mouth, 
and  is  also  in  a  slight  degree  bitter.  In  addition  to  the  preceding  con- 
stituents of  bile,  there  are  Taurin,  Cholic  acid,  and  a  coloring  matter. 
In  a  recent  analysis  of  the  bile,  by  Berzelius,  he  has  been  induced  to 
believe  that  the  principal  element  of  bile  is  a  substance  which  he  calls 
Bilin,  easy  to  decompose,  and  by  the  aid  of  acids  convertible  into 
several  other  bodie^. 

1  Called  from  its  bitter  sweet  taste. 


58  CHEMICAL  COMPOSITION. 


Urea  and  the  Uric  Acid. 

Urea  is  found  principally  in  the  urine.  It  is  also  in  the  blood  and  in 
the  secretions  from  it  when  the  function  of  the  kidneys  has  been 
invaded  either  by  disease  or  by  the  ablation  of  these  organs. 

It  is  readily  obtained  by  evaporating  the  urine  to  a  syrup,  then 
adding  nitric  acid  to  it,  so  as  to  make  a  nitrate  of  urea.  The  nitric 
acid  may  afterwards  be  detached  by  carbonate  of  barytes,  and  the  urea 
being  then  dissolved  in  alcohol,  the  latter  is  driven  off  by  evaporation. 

Uric  acid  is  found  in  the  urine  of  carnivorous  animals,  and  also  in 
urinary  and  in  arthritic  calculi.  The  urine  of  serpents  and  of  birds  is 
formed  almost  wholly  from  the  urate  of  ammonia.  This  salt  is  pre- 
cipitated in  a  state  almost  perfectly  pure  from  the  human  urine  by 
the  influence  of  a  low  temperature.  The  precipitate  is  at  first  powdery 
and  gray,  the  color  afterwards  changes  to  a  pale  rose  hue,  and  by 
drying,  it  assumes  the  form  of  scales,  which  are  the  smaller  as  the  acid 
approaches  a  pure  state. 

The  preceding  substances  enumerated  and  described  as  Protein  and 
its  products,  also  the  Extractiform  Substances,  the  Collin,  or  Gluey 
ones,  Hsematin,  the  constituents  of  Bile,  Urea  and  Uric  acid,  are  all 
distinguished  by  a  large  proportion  of  nitrogen  in  their  chemical  com- 
position. 

We  have  next  to  take  into  consideration  certain  animal  matters, 
which  are  destitute  naturally  of  Nitrogen ;  these  are  Sugar  of  Milk ; 
Lactic  acid;  Saponifiable  Fats;  the  Non-Saponifiable  Fats;  Fatty 
Bases,  and  Fatty  Acids. 

Sugar  of  Milk. 

Sugar  of  Milk  is  found  in  the  milk  of  woman  and  in  that  of  the 
females  of  all  mammiferous  animals.  In  some  cases  where  the  secre- 
tion of  the  mamma  has  been  suppressed,  it  has  been  found,  or,  at  least, 
supposed  to  be  in  the  fluids,  secreted  from  the  intestines  or  deposited 
in  the  peritoneal  cavity.  A  case  of  the  latter  kind  occurred  to  Schreger 
in  the  year  1800.1 

It  makes  about  two-fifths  of  the  solid  residuum  of  milk  when  this 
fluid  has  been  evaporated  to  dryness,  and  may  be  obtained  by  depriving 
the  milk  of  its  butter  and  cheesy  matter,  and  then  evaporating  it  to  the 
consistence  of  a  syrup.  When  it  gets  cool  the  saccharine  matter  is 

1  Encyclop.  Anat.  vol.  vi.  p.  100. 


LACTIC  ACID.  59 

deposited  in  crystals,  and  it  may  then  be  purified  by  successive  solu- 
tions followed  by  crystallizations. 

The  specific  gravity  of  sugar  of  milk  is  1.543.  Its  crystals  are  four- 
sided  prisms,  having  a  lamellar  arrangement,  and  ending  in  pyramids 
with  four  faces.  It  is  much  harder  than  sugar  candy,  has  a  moderately 
sweet  taste,  and  one  which  is  somewhat  gravelly.  It  is  soluble  in  about 
six  parts  of  cold  water,  but  does  not  dissolve  in  pure  alcohol  or  in  ether. 
The  properties  of  it  are  somewhat  different  when  taken  from  the 
human  female  and  from  the  cow.  Its  concentrated  aqueous  solution 
turns  spontaneously  into  lactic  acid.  Its  elements,  according  to  Liebig, 
are  12  atoms  of  Carbon,  24  of  Hydrogen,  and  2  of  Oxygen.  Various 
compounds  are  formed  by  treating  it  with  chlorine,  sulphuric  acid,  nitric 
acid,  and  other  articles. 


Lactic  Acid. 

Lactic  Acid  exists  either  free  or  in  combination  with  different  bases, 
in  all  the  liquids  and  secretions  of  the  body.  In  the  free  state,  it  is 
found  in  meat,  in  perspiration,  in  urine,  and  in  milk.  The  bases  with 
which  it  is  in  combination  are  soda,  potash,  lime,  magnesia,  ammonia, 
and  urea.  It  is  not  only  obtained  from  animal  matter,  but  is  produced 
in  the  fermentation  of  certain  vegetables  which  produce  starch  and 
sugar. 

The  process  for  getting  it  from  milk  is  as  follows :  A  quantity  of 
sour  whey  is  to  be  evaporated  to  one-sixth  of  its  weight,  and  then  fil- 
tered. The  phosphoric  acid  in  it  is  then  precipitated  by  chalk,  and 
afterwards  the  excess  of  the  chalk  is  to  be  corrected  by  oxalic  acid. 
The  liquor  is  then  filtered  again,  the  fluid  part  of  it  is  evaporated,  the 
lactic  acid  is  then  taken  up  by  alcohol  which  leaves  the  sugar  of  milk. 
The  alcohol  is  then  to  be  evaporated,  and  the  residuum  is  Lactic  Acid. 
To  purify  it,  however,  perfectly,  requires  some  other  steps  well  known 
to  chemists. 

The  lactic  acid  does  not  continue  in  the  dry  or  anhydrous  state,  unless 
in  combination  with  some  base.  When  in  the  pure  hydrated  condition, 
it  forms  a  colorless  syrup,  extremely  acid,  without  smell,  and  having  a 
specific  gravity  of  1.215.  It  is  only  dissolved  to  a  very  small  extent  in 
ether,  but  has  no  limits  as  regards  water  and  alcohol.  It  coagulates 
albumen  and  casein,  and  its  action  is  much  accelerated  on  them  by  the 
assistance  of  heat.  It  was  formerly  confounded  with  acetic  acid,  but 
the  difference  is  now  well  established  in  its  want  of  volatility  and  of 
odor. 

Lactic  acid  dissolves  phosphate  of  lime  very  rapidly,  by  which  quality 
is  explained  the  quantity  of  this  salt  held  in  solution  by  milk,  urine, 


60  CHEMICAL  COMPOSITION. 

and  other  secretions.  It  has  also  been  suggested  by  Marchand  that 
the  presence  of  an  excessive  quantity  of  this  acid  in  the  system  causes 
a  softening  of  the  skeleton  by  preventing  the  deposit  of  phosphate  of 
lime  into  the  bones,  and  also  dissolving  that  which  already  exists  in 
them.  Its  atomic  proportions  are,  Carbon  6,  Hydrogen  10,  Oxygen  5. 
It  is  kept  very  conveniently  in  the  form  of  lactate  of  barytes,  or  of 
lead,  and  forms  with  these  bases  a  mass  which  resembles  gum.  Being 
superior  in  strength  to  acetic  acid,  it  drives  it  from  its  combinations. 
Boiled  in  strong  nitric  acid,  the  latter  acid  seizes  to  some  extent  upon 
its  oxygen,  and  produces  oxalic  acid. 

Fatty  Substances. 

These  productions  of  the  animal  body  are  destitute  of  nitrogen,  and, 
as  a  common  character,  are  insoluble  in  water,  but  soluble  in  hot  alcohol 
and  in  ether.  Some  of  them  are  saponifiable  or  capable  of  being  con- 
verted into  soap  by  union  with  an  alkali ;  the  same  also  unite  readily 
with  oxides  of  lead,  so  as  to  form  plasters.  This  habit  is  in  virtue  of 
an  acid  existing  in  them,  and  which,  being  naturally  united  to  a  base, 
leaves  that  base  and  attaches  itself  to  another,  as  the  alkali  or  the  lead. 
The  acids  and  the  bases  themselves  are  oxides  of  compound  radicals, 
supposed  to  be  carburets  of  hydrogen. 

Another  series  of  fatty  bodies  cannot  be  converted  into  soap,  and 
there  is  a  doubt  among  chemists  how  they  ought  to  be  classed,  whether 
among  the  fats  which  have  a  base,  or  as  neuter  organic  matters. 
Among  these  peculiar  organisms  are  Cholesterin  and  Serolin. 

Cholesterin  is  found  in  bile,  hence  its  name  ;  also  in  the  blood,  and 
in  the  medullary  nervous  matter  ;  it  is  also  observed  in  the  secretions, 
in  morbid  tissues,  in  cysts,  in  hydatids,  in  the  water  of  dropsy,  in  me- 
dullary fungi  and  in  other  tumors. 

Cholesterin,  in  its  pure  state,  crystallizes  in  laminae,  of  a  brilliant 
mother-of-pearl  color,  soft  to  the  touch  an<J  sometimes  very  large.  It 
is  inodorous  and  insipid,  dissolves  readily  in  hot  alcohol  or  ether,  but 
not  in  water.  It  may  be  obtained  from  biliary  calculi  by  boiling  them 
in  water,  and  afterwards  in  alcohol ;  when  the  latter  cools,  the  choles- 
terin  is  separated  by  crystallization.  Its  chemical  components  are 
carbon  85.095,  hydrogen  11.880,  oxygen  3.025.  Treated  with  nitric 
acid,  it  forms  cholesteric  acid. 

Serolin  is  so  called  from  its  being  obtained  from  the  blood;  an  original 
observation  of  Boudet.  It  may  be  procured  by  boiling  dried  blood  in 
alcohol ;  it  separates  from  the  latter  on  its  cooling,  and  floats  about  in 


SAPONIFIABLE  FATS.  61 

flocculi  of  a  pearl  color,  of  a  fatty  feel,  and  acting  neither  after  the 
manner  of  acids  nor  of  alkalies.  When  examined  by  the  microscope,  it 
is  seen  to  consist  in  filaments,  which  are  swollen  out  in  a  globular  form 
from  place  to  place.  It  is  susceptible  of  sublimation  almost  without 
any  alteration. 

Of  the  Saponifiable  Fats. 

There  are  three  substances  which  perform  the  part  of  base  to  animal 
fat :  glycerin,  the  oxide  of  cetyle,  and  cerain.  The  first  forms  the  base 
of  human  fat,  and  is  more  universally  diffused  in  the  animal  kingdom  ; 
the  second  exists  in  spermaceti ;  and  the  third  in  wax. 

Glycerin  is  separated  from  fat  in  the  act  of  the  latter  forming  soap 
with  an  alkali ;  but  it  may  be  obtained  in  the  highest  purity  by  boiling 
an  oxide  of  lead  in  fat ;  the  acid  of  the  latter  attaches  itself  to  the  lead, 
and  the  glycerin  is  left  free,  being  dissolved  in  the  water,  from  which 
it  may  be  disengaged  and  purified  by  a  particular  process. 

Glycerin  is  a  clear  liquor,  somewhat  yellow,  without  odor  and  some- 
what sweet :  it  is  very  soluble  in  water  or  alcohol ;  not  soluble  in  ether. 
It  dissolves  readily  iodine,  the  vegetable  acids,  the  deliquescent  salts, 
the  sulphate  of  soda,  of  potash,  of  copper,  nitrate  of  silver,  and  many 
other  articles. 

Glycerin  being  the  base  of  human  fat,  the  acids  which  are  found  in 
combination  with  it  are  the  stearic,  margaric,  and  oleic  ;  and  the 
result  of  such  combinations  forms  the  fatty  matters  called  stearin, 
margarin,  and  olein.  Butter  has  also  its  Own  peculiarities  in  being 
formed  of  glycerin,  in  union  with  butyric,  capric,  and  caproic  acids ; 
and  even  the  cerebral  matter  presents  a  peculiar  acid  united  to  gly- 
cerin, and  called  by  Fremy  the  cerebric  acid,  and  an  oleo-phosphoric 
acid. 

The  Stearic  and  Margaric  acids  are  obtained  pure  by  a  process 
which  is  complicated  and  prolonged ;  they  are  very  feeble,  but  at  an 
elevated  temperature  drive  carbonic  acid  from  its  combinations.  Their 
union  with  glycerin  makes  the  principal  part  of  the  fat  of  the  human 
body. 

The  Oleic  acid  is  an  oleaginous  liquor,  of  a  clear  yellow  :  it  is  very 
acid,  and  has  a  rancid  smell  and  taste.  It  is  insoluble  in  water,  but 
very  soluble  in  alcohol.  The  olein  which  it  forms  by  union  with  gly- 
cerin is  in  a  fluid  state  naturally,  but  is  kept  so  at  degrees  of  tempera- 
ture varying  in  the  different  animals. 

The  above  acid  and  basic  constituents  of  animal  fats  are  seldom  found 
insulated,  being  almost  always  under  the  combinations  alluded  to  above  ; 
a  departure  from  this  rule  exists  occasionally  with  the  acids,  but  never 


62  CHEMICAL  COMPOSITION. 

with  the  base  or  glycerin.  The  fats  under  the  form  of  stearin,  mar- 
garin, and  olein  are  blended  in  the  adipose  tissue  of  the  cellular  sub- 
stance, and  in  the  fat  of  the  bones  or  marrow  as  it  is  called.  The  con- 
sistence of  the  fat  depends  upon  their  relative  quantity  in  it.  Thus 
Olein  predominates  in  oil  or  the  fluid  part  of  fat,  it  commonly  not  being 
in  great  quantity  in  the  human  subject;  but  there  are  individuals  of 
enormous  obesity  in  whom  its  proportion  is  excessive,  so  that,  in  making 
a  necropsy  of  such  in  warm 'weather,  the  oil  runs  all  about.  Margarin 
is  next  in  consistence,  and  forms  lard,  such  as  is  found  in  the  hog  and 
in  the  bear.  Stearin  forms  suet,  and  is  found  to  a  remarkable  degree 
in  the  fat  of  the  sheep,  and  of  the  bullock. 

Fat,  besides  being  in  the  cellular  substance  and  in  bones,  prevails  to 
a  great  extent  elsewhere  in  the  human  body,  as  in  the  composition  of 
the  brain.  It  is  found  in  chyle,  blood,  pus,  bile,  milk,  and  sometimes 
in  urine.  In  milk  and  chyle  its  globules  are  in  little  vesicles.  Its 
different  modifications  exist  in  the  vegetable  kingdom  ;  as  stearin  in 
the  cocoa-nut  butter  ;  margarin  in  palm  oil ;  and  olein  in  flax-seed  oil, 
and  many  others. 


HISTOGENY.1 


OR    THE 


ORIGIN  OF  THE  ELEMENTARY  TISSUES. 


CHAPTER  III. 

IN  animals,  we  find,  at  an  early  period  of  their  evolution,  and  during 
their  whole  life,  corpuscles  so  exceedingly  fine  as  to  require  a  micro- 
scope to  see  them  distinctly.  They  have  a  certain  characteristic  shape 
and  are  called  elementary  cells,  primitive  cells,  and  also  nucleated  cells, 
from  the  existence  of  a  small  point  or  nucleus 
within  them.  They  are,  in  fact,  vesicles  with  pa-  Flg>  l' 

rietes  extremely  attenuated,  contain  a  fluid  of  some 
kind,  occasionally  granular  ;  and  have  attached  to 
their  walls  or  lying  loosely  a  smaller  body,  which 
is  called  the  kernel  or  Nucleus,  and  also  Cytoblast, 
in  the  language  of  Schwann.3  The  nucleus  pre- 
sents, on  most  occasions,  one  or  two  spots  or  points, 
of  a  regularly  rounded  shape,  and  which  go  under  Primary  organic  ceil, 

TIT      T       T          mi  i  -i  o   •          n  showing     the    cell-mem- 

the  name  Of  Nucleoll.        The  nUCleUS    itself  IS    Of    a      brane,   the    nucleus,   and 

rounded,  or  ovoidal  shape,  somewhat  flattened,  is 

colorless  or  of  a  reddish  yellow,  smooth,  or  granular  like  a  raspberry, 

in  which  case  its  nucleoli  are  imperceptible.     Its  diameter  is  from  the 


1  Fiom  iffTo;  texture,  and  j/evsrj;  generation. 

2  From  Kfrof  cell,  and  £xacro?,  germ. 

3  The  Cytoblast  or  Cell-germ  had  been  long  understood  as  an  essential  and  generally  dif- 
fused  constituent  of  vegetable   structures,  when,  in   1838,  its  especial  importance  in   the 
development  of  vegetables  was  declared  by  Schleiden.  (See  Mailer's  Archives,  1838.)     After 
that  Valentin  (see  Wagner's  Elements  of  Physiology,  Lond.  1841,  translated  by  Willis),  and 
subsequently  Schwann  in  1839   (see  Micros.  Inquir.,  &c.,  Berlin,  1839)  declared  the  iden- 
tity in  office  and  in  structure  of  the  cell-germ  in  both  vegetables  and  animals.    This  analogy 
of  structure  is  so  close  that  the  description  of  one  may  be  applied  almost  exactly  to  the  other^ 
by  the  admission  of  the  most  approved  microscopists.  (See  Gerber,  Gen.  Anat.  Lond.  1842, 
p.  40.) 


64  HISTOGENY. 

two  to  the  four-thousandth  part  of  a  line,  or  from  the  ^J^  to  the 
Wo  o  °f  an  incn<  This  nucleus  appears  sometimes  itself  to  be  made 
out  of  a  membranous  envelop  with  a  contained  fluid. 

The  above  elementary  cells,  at  an  early  period  of  their  existence,  are 
soluble  in  acetic  acid,  the  nuclei  being  left  behind  ;  the  nucleoli  are  to 
the  same  degree  indestructible  by  this  agency.  The  nucleoli  are  of  a 
doubtful  character,  it  being  unsettled  whether  they  are  stains,  globules, 
lacunae,  or  vesicles  in  the  nuclei.  Schwann  says  that  they  are  upon 
the  outside  of  the  nuclei  in  the  round  cells,  and  on  the  inside  of  the 
nuclei  of  the  concave  cells. 

The  walls  of  primary  cells  are  homogeneous  or  amorphous,  i.  e.  they 
appear  to  have  extension  with  the  least  conceivable  thickness,  are  per- 
fectly smooth  under  the  highest  magnifying  powers,  and  have  neither 
filaments  nor  granulations,  nor  anything  else  indicative  of  an  inter- 
rupted surface.  The  best  idea  of  them  would,  perhaps,  be  derived  from 
the  inspection  of  a  very  small  soap  bubble. 

The  elementary  cells  are  situated  in  a  substance  also  amorphous,  and 
called  by  Schwann  Cytoblastema,  and  which  executes  the  office  of  an 
intercellular  substance.  When  this  intercellular  substance  is  liquid, 
the  primary  cells  float  freely  about  in  it,  as  in  the  case  of  the  blood  ; 
but  when  the  cytoblastema  has  more  consistence,  the  cells  are  fixed  to 
their  places,  and  even  glued  together  with  some  tenacity  ;  with  a  force, 
in  fact,  requiring  a  special  solvent  to  free  them. 

The  progress  of  these  primary  cells  may  be  studied  in  the  incubated 
egg,  in  the  tissues  of  the  body  which  are  in  a  constant  state  of  repro- 
duction, as  the  nails  and  hairs,  and  also  in  the  exudations  of  fibrin 
which  occur  on  inflamed  surfaces.  The  vegetable  kingdom,  also, 
according  to  Schwann,  presents  analogies  or  repetitions  of  the  process 
precisely  identical  with  what  occurs  in  the  animal  kingdom. 

The  phenomena  are  as  follow.  An  amorphous  fluid  by  some  internal 
change  becomes  granular.  This  amorphous  fluid  is  gum  in  a  plant,  but 
albumen  in  an  animal.  The  first  perceptible  change  from  this  condi- 
tion of  uniform  and  unclouded  transparency  is  the  appearance  of 
numerous  extremely  minute  granules,  which  make  the  fluid  turbid. 
This  state  having  remained  for  a  short  time,  certain  granules  larger 
and  more  defined  than  the  others  are  seen,  and  appear  to  augment  by 
collecting  the  finer  ones  around  them.  This  is  the  first  state  of  nucleus, 
or  cytoblast,  or  cell-germ,  as  it  is  also  called.1  From  the  surface  of 

1  The  discovery  of  this  germinal  coagulation,  as  the  first  formative  act,  has  been  attributed 
to  Schleiden,  see  Mullet's  Archives,  1838,  and  to  Schwann,  see  Mikroskopische,  &c.,  1839. 
A  much  more  ancient  author  may,  however,  be  quoted  with  greater  propriety  in  the  following 
words,  "  Nonrie  sicut  lac  mulsisti  me,  sicut  caseum  me  coagulasti?  Hast  thou  not  poured 
me  out  as  milk,  and  curdled  me  like  cheese?"  Job  x.  10. 


ELEMENTARY  CELLS.  65 

each  cytoblast   a   delicate  membrane  Fig-  2- 

rises    up   in   an   attitude   resembling 
that  of  a  watch  glass  to  the  dial ;  this  fi) 

membrane  increases  in  extent  and  mag- 
nitude,  until  it  envelops  the  cytoblast    C^^T^ 
so  completely  that  the  latter  is  seen    ing  t( 

merely  as  a  nucleus  on  its  wall.  The  consistence  of  the  cell  is  for 
some  time  very  soft,  and  occasionally  it  disappears  from  trifling  dis- 
turbances, as  a  slight  agitation  in  the  surrounding  fluid. 

According  to  Schleiden,  the  function  of  the  nucleus  ends  with  the 
evolution  of  the  cell,  but  others  hold  that  the  granules  of  which  it  is 
composed  become  the  germinal  points  of  other  cells,  to  be  developed 
within  the  original  one. 

The  elementary  granules  being  the  first  indications  of  a  rule  of  form, 
or  distinctly  defined  shape,  the  opinion  is  entertained,  from  the  present 
state  of  our  knowledge,  that  they  are  vesicles  consisting  in  a  small 
sphere  or  particle  of  fat,  enveloped  by  a  membrane.  The  existence 
of  a  membrane,  though  then  invisible,  would  seem  to  be  proved  by 
the  circumstance  that  the  spherules  are  kept  apart  in  this  miniature 
state,  but  when  they  have  augmented,  then  the  exterior  envelop  is 
absolutely  seen.  The  envelop  itself  is  considered  as  a  modification 
of  Protein,  and  is  soluble  in  acetic  acid,  upon  which  being  done  the 
granulations  readily  coalesce,  and  are  easily  dissolved  in  boiling 
ether  or  alcohol,  which  they  had  previously  resisted. 

The  above  modification  of  protein  is,  probably,  albumen ;  and  an 
observation  bearing  on  this  point  was  originally  made  by  Ascherson — 
to  wit :  that  albumen  never  fails  to  coagulate  in  a  membranous  form 
when  it  comes  in  contact  with  fat.  Under  this  law  a  particle  of  grease 
cannot  for  a  moment  be  in  contact  with  albumen,  without  the  latter 
being  drawn  over  it  in  a  membranous  form.  A  drop  of  each  of  these 
substances  in  a  fluid  state,  put  in  contact  on  a  plane  surface,  exhibits 
instantaneously  this  phenomenon,  in  the  formation  of  a  delicate  and 
elastic  membrane  around  the  fat,  and  which  covers  itself  with  numerous 
elegant  folds.  Oil  and  albumen,  shaken  in  mass  together,  exhibit  the 
same  upon  a  larger  scale.  A  decisive  proof  of  the  existence  of  the  cap- 
sule of  albumen  thus  formed,  is  that  a  process  of  exosmosis  and  of  en- 
dosmosis  occurs  in  its  parietes,  so  that  a  fluid  having  an  affinity  for  the 
oil  makes  the  capsule  expand  or  contract  into  wrinkles,  according  to 
circumstances,1  upon  its  being  brought  into  contact  with  the  capsule. 

This  striking  experiment  has  been  seized  upon  by  Henle  to  elucidate 
what  occurs  in  the  formation  of  living  elementary  granules.  Fat  and 

1  Encycl.  Anat.  p.  164,  vol.  vi. 
VOL.  I. — 5 


66  HISTOGENY. 

the  combinations  of  protein  are  incessantly  introduced  into  the  system 
by  the  action  of  the  animal  organism  on  aliments,  so  that  they  are  found 
in  the  chyle,  in  the  blood,  and  in  all  the  fluids  of  the  body.  The  fat  on 
its  formation  becomes  quickly  surrounded  by  a  film  of  albumen,  so  as 
to  prevent  its  particles  from  collecting  into  masses  of  large  size,  and 
the  particles  thus  situated  may  become  elementary  granules  in  being 
deposited  in  the  texture  of  organs. 

It  is  not,  however,  pretended  that  a  process  so  purely  physical  as  the 
formation  of  a  film  around  a  drop  of  fat  gives  all  the  explanations  requi- 
site for  the  understanding  of  a  vital  process ;  for  an  organic  cell  and 
an  artificial  one  are  as  different  from  each  other  as  a  dead  body  is  from 
a  living  one.  Chance  alone  produces  the  resemblance,  so  far  as  it  exists 
in  form ;  the  vital  force  of  one  makes  afterwards  an  incomprehensible 
and  unlimited  difference. 

It  may  here  be  remarked  that  the  globules  of  fat,  common  to  the  fluids 
of  the  body,  are  kept  when  in  a  healthy  state  within  certain  limits  of 
magnitude  ;  and  that  in  the  case  of  pus,  it  is  of  a  bad  nature  when  the 
fat  globules  collect  into  large  drops ;  hence  the  latter  are  seldom  or  never 
seen  in  pus  of  a  good  quality. 

Jn  the  estimate  of  the  sources  of  elementary  cells,  it  may  also  be 
remarked,  that  there  is  another  act  of  the  animal  body  exhibiting  some 
analogy.  It  is  known,  for  instance,  that  fibrin,  in  coagulating,  forms 
naturally  a  reticulated  or  cellular  arrangement  containing  serum ;  in 
some  cases  even  vesicles  are  thus  produced,  when  a  clot  remains  for 
some  time  in  a  living  vessel  or  canal ;  and  sometimes  such  vesicles  are 
seen  erecting  themselves  so  as  to  be  appended  only  by  a  pedicle.  Henle 
has  seen  this  assumed  cellular  arrangement  containing  serum,  in  polypi 
of  the  heart ;  in  the  membrane  of  croup ;  and  in  the  plastic  exudations 
of  the  womb,  and  of  the  intestinal  canal.  He  concludes,  therefore,  that 
many  hydatids  come  from  such  cells  taking  on  a  spontaneous  growth. 
Dujarden  has  observed  a  similar  process  to  the  above  in  an  exudation, 
which  he  calls  Barcode,  coming  from  the  bodies  of  dying  infusory  ani- 
malcules, and  from  the  fragments  of  the  higher  animals.  In  this  matrix 
are  generated  small  insulated  globules,  that  finally  acquire  a  larger  size 
at  the  expense  of  the  matrix,  which  ultimately  collapses,  and  is  reduced 
to  a  very  small  residuary  matter.1 

Another  hypothesis  in  histogeny  is  that  of  Kaspail  and  of  Schwann, 
who  see  in  the  elementary  cells  phenomena  analogous  to  the  formation 
of  crystals  in  inorganic  matter ;  the  difference  being  that  these  organic 
crystals  execute  an  imbibition  of  new  molecules  for  their  growth,  while 
inorganic  crystals  grow  merely  by  superposition.  The  points  in  detail 

1  Encycl.  Anat.  vol.  vi.  p.  16. 


ELEMENTARY  CELLS. 


67 


Fig.  3. 


of  this  theory  are  so  much  in  the  line  of  gratuitous  assumption,  that 
much  remains  yet  to  render  it  acceptable. 

Upon  the  multiplication  of  cells  depend  the  reproduction  and  growth 
of  the  body.  In  some  cases  these  cells  are  secreted  in  succession  from 
a  matrix  ;  which,  in  the  case  of  the  epidermis,  the  nails,  and  the  hairs, 
is  the  cutis  vera.  Each  cell  in  them  is  developed  in  an  insulated  man- 
ner, and  reaches  its  perfect  state  by  its  formative  force  alone.  This 
occurs  in  tissues  having  but  an  inferior  degree 
of  vitality  as  the  above.  But  in  the  majority 
of  instances,  the  formation  of  one  cell  depends 
upon  the  action  of  pre-existing  cells.  It  be- 
comes an  act  of  generation,  wherein  the  new 
cell  forms  at  first  an  appendage  to  an  older 
one ;  the  older  cells  finally  disappear  and  are 
succeeded  in  full  by  the  new  cells ;  and  this  act 
of  succession  in  generations  is  constantly  going 
on  during  the  life  of  the  individual.  This  pro-, 
cess  reduces  animal  life  to  an  evolution  of  co- 
temporaneous  and  intercurrent  generations  of 
monades :  each  generation  parting  with  its  vi- 
tality in  behalf  of  proximate  succeeding  genera- 
tions, but  in  such  a  way  that  the  life  of  the 
whole  system  is  continually  kept  up.  In  gene- 
ral death,  the  act  of  regeneration  is  of  course 
universally  arrested. 

The  generation  of  cells  as  above  is  produced  in  two  ways,  one  called 
exogenous  from  its  occurring  in  the  form  of  an  excrescence  or  sprout 
on  the  exterior  of  preceding  cells.  Henle  considers  this  act  to.  be  con^ 
fined  to  the  lower  conditions  of  vegetable  life.*  On  the  contrary, 
ler  asserts  it  as  of  common  occurrence  in  many  animal 
tissues,  In  this  case  the  cytoblastema  or  matrix  of  the 
new  cell  is  on  the  exterior  of  the  older  one.  The  other 
mode  is  called  endogenous,  because  it  occurs  within  the 
circle  of  the  old  cell*  from  the  cytoblastema  which  it  con- 
tains, The  most  conclusive  proof  of  the  latter  is  pre- 
sented in  the  development  of  the  Embryo,,  at  the  expense 
of  the  granular  contents  of  the  yolk  of  an  egg.  From 
the  observations  of  the  German  physiologists  it  appears, 
that  in  certain  molluscous  animals  the  firs,t  act  of  evo- 
lution of  a  germ  is  the  appearance  of  three  qr  four 


Oblique  section  of  Epjder- 
mis,  showing  the  progressive 
development  of  component 
cells.  —  a.  Nuclei,  resting 
upon  the  surface  of  the  cutis 
vera.  f.  These  nuclei  are 
seen  to  be  gradually  deve- 
loped into  cells,  at  6,  c,  and  d : 
and  the  cells  are  flattened 
into  lamellae,  forming  the  ex- 
terior portion  of  the  epider- 
mis at  e. 


Fig.  4. 


Scheme  from  Dr. 
Barry.  showing 
young  cells  grow- 
ing within  a  larger 
one  in  concentric 
series.  One  of  the 
young  cells  is  re- 
presented as  filled 
with  a  still  young- 
er generation. 


yol.  vi.  p.  172. 


68  HISTOGENY. 

globules ;  these  contain  others,  which  grow  in  their  turn,  and  distend  the 
preceding  ;  then  a  third  generation  occurs  within  the  walls  of  the  second, 
and  so  on  successively  until  a  homogeneous  mass  of  cells  is  formed, 
which  shows  almost  completely  the  form  of  the  young  animal.1  Morbid 
productions  assist  in  throwing  light  upon  this  point  of  inquiry.  Valentin 
has  observed  in  carcinoma  a  cell  containing  two  others,  each  provided 
with  a  nucleus.  J.  Muller  has  witnessed  young  cells  enclosed  in  older 
ones  in  cases  of  medullary  sarcoma  and  some  other  cancerous  affections. 

In  healthy  tissues  the  same  experience  exists,  for  example,  in  the 
formation  of  cartilage  and  in  the  growth  of  glands.  The  granules  of 
mucus  are  nucleated  cells  ;  those  of  pus  and  lymph  also.  Schultz  was 
the  first  to  discover  that  the  blood-disks  or  corpuscles  are  of  the  same 
description,  the  matter  which  gives  them  a  color  being  contained  within 
them.2 

In  the  vegetable  kingdom  young  cells  are  generated  by  partitions 
traversing  the  interior  of  the  older  cells :  the  divisions  which  occur  in 
the  interior  of  the  yolk  of  an  egg  are  considered  as  an  analogy,  in  the 
animal  kingdom,  to  this  process,  though  with  that  exception,  the  ex- 
amples are  deficient. 

As  each  tissue  of  the  body  can  produce  cells  of  an  assimilated  nature 
to  itself,  so  when  accidents  occur  to  such  tissues,  as  in  the  case  of  a 
ruptured  bone  or  muscle,  the  ruptured  ends  take  on  a  similar  action  for 
the  repair  of  the  accident.  The  proceeding  is  modified  according  to 
the  tissue ;  if,  however,  in  those  accidents  the  ruptured  ends  be  kept 
too  far  apart,  the  action  does  not  extend  to  a  sufficient  distance,  and 
the  cure  is  incomplete,  the  intermediate  substance  not  conforming  to  a 
proper  nature.  In  most  instances,  common  cellular  substance  supplies 
the  deficiency.  It  is  under  this  law  that  Henle  has  asserted  that  light 
and  repeated  congestions  are  followed  by  simple  hypertrophy,  as  in  the 
muscles  and  epidermis,  while  greater  congestions  produce  degeneration, 
induration,  and  suppuration. 

In  the  early  state  of  the  foetus,  we  find  nothing  but  cells.  They  are 
held  together  by  a  substance  which  is  called  hyaline,  from  its  resem- 
blance to  glass,  that  is,  being  smooth,  shining,  destitute  of  fibres,  and 
exactly  homogeneous  in  its  appearance.  Occasionally  this  intercellu- 
lar substance  is  granular,  or  even  filamentous.  The  cells  themselves,  in 
the  ulterior  development  of  the  being,  undergo  for  the  most  part  meta- 
morphoses which  finally  bring  them  into  the  condition  of  the  several 
tissues  enumerated  at  the  beginning  of  this  treatise*  as  representing  the 

classification  of  Bichat.     Some  of  the  cells  retain,  however,  perma- 

* 

1  Encycl.  Anat.  vol.  vi.  p.  173.  2  Muller,  Physiol.  p.  1644. 


CILIA.  69 

nently  their  original  character.  The  formation  of  cells  is  though,  as 
previously  remarked,  not  limited  to  any  period  of  life,  but  is  constantly 
going  on,  as  these  minute  organic  bodies  are  interposed  in  all  the 
functions  of  life,  being  involved  in  the  secretions,  connected  with  nutri- 
tion, found  floating  in  numbers  in  all  the  assimilated  fluids,  and  par- 
ticipating largely  in  inflammatory  actions. 

One  might  infer  from  the  simplicity  of  this  inceptive  step  of  an 
organized  being,  that  is,  the  presence  of  a  mere  cell  from  which  others 
are  generated,  either  internally  or  externally,  that  wherever  an  organic 
compound,  as  protein,  or  any  of  its  cognates  existed,  there  would  be  a 
spontaneous  evolution  of  animal  life  in  it,  without  the  aid  of  fecunda- 
tion. This  opinion  has  in  fact  had  numerous  supporters  and  is  not 
destitute  of  advocates  at  the  present  day ;  but  the  progress  of  know- 
ledge is  revealing  constantly  so  many  exceedingly  minute  forms  of 
animal  and  of  vegetable  life,  that  it  leaves,  as  the  strongest  ground  of 
inference,  that  in  all  cases  of  apparently  spontaneous  generation,  ovula 
have  been  invisibly  deposited  in  and  around  the  matrix.  Moreover, 
recent  experiments  show  that  neither  vegetation  nor  animalcular  evolu- 
tion will  be  exhibited  in  fluids  which  have  been  subjected  to  such 
processes  as  must  inevitably  kill  any  germs  which  may  have  been 
deposited  in  them. 

From  the  state  then  of  nucleated  cells,  as  described  in  the  foregoing 
pages,  all  the  tissues  may  be  traced  as  they  exist  in  the  perfect  and 
mature  animal.  The  metamorphoses  of  the  cell  are  found  to  have 
affected  both  its  walls  and  the  nucleus. 

In  some  instances,  the  cells  continue  independent  of  each  other,  there 
being  no  disposition  to  coalesce ;  this  habit  is  remarked  in  the  case  of 
the  circulating  fluids  as  in  the  corpuscles  of  the  blood,  in  those  of  the 
lymph  and  the  chyle,  in  the  epidermis,  some  pigment  membranes,  and 
the  fat  cells.  In  certain  cases,  such  cells  grow  largely  ;  for  example,  a 
young  elementary  fat  cell  will  be  found  at  first  only  the  ^ou^h  °f  aline 
in  diameter  and  subsequently  grows  to  be  the  4  J^th  of  a  line.  The  shape 
of  cells  is  also  modified  very  much  by  pressure ;  some  are  flattened,  some 
are  pentagonal  or  hexagonal,  some  cylindrical,  some  prismatic,  some 
cuneiform  or  conical. 

A  very  singular  metamorphosis  of  certain  cells  is  where  they  produce 
at  one  side,  or  at  various  points,  small  thread-like  elongations  or 
fringes,  called  Cilia,  from  their  resemblance  to  the  eyelashes.  Such 
fringed  cells  are  generally  flattened,  whatever  may  be  their  shape, 
whether  pentagonal,  cylindrical,  or  conoidal ;  and  are  placed  upon 
free  or  non-adherent  surfaces. 

These  Cilia,  according  to  Purkinje  and  Valentin,  are  flattened,  their 


70  HISTOGENY. 

points  being  rounded  off;  some  are  fusiform;  and  their  length  is 
from  about  TQ^O*^  to  T2?o(5tn  °f  an  inch-1  They  are  disposed  in  rows 
of  some  regularity.  During  life,  and  for  some  time  after  its  extinc- 
tion, they  have  a  sensible  waving  motion,  resembling  that  of  a  field 
of  wheat  agitated  by  a  steady  breeze,  each  one  bending  forwards  and 
back  again,  and  having  also  a  gyratory  motion.  The  action  of  the 
cilia  produces  a  current  in  the  fluid  contiguous  to  them,  the  course  of 
which  may  be  rendered  very  plain  by  mixing  with  the  fluid  particles 
of  finely-powdered  charcoal.  The  integrity  of  the  cells,  to  which  the 
cilia  belong,  is  essential  to  this  motion ;  for,  if  they  become  dry  or 
altered  by  putrefaction  or  chemically,  the  cilia  cease  to  play.  The 
scrapings  of  the  throat  of  a  frog  are  well  suited  to  this  display  of  epi- 
thelial ciliary  motion.  On  one  occasion,  the  latter  was  seen  to  last 
for  seventeen  hours,  in  a  frog.  In  a  turtle's  mouth,  it  was  found  to 
last  for  nine  days  after  decapitation ;  in  t*he  trachea  and  lungs  for 
thirteen  days,  and  in  the  oesophagus  for  nineteen  days.2  It  appears 

Fig.  5. 

wmwmmwmm 


Examples  of  Cilia  : — 1.  Portion  of  a  bar  of  the  gill  of  the  Sea-mussel,  Mytilus  edulis,  showing  cilia 
at  rest  and  in  motion.  2.  Ciliated  epithelium  particles  from  the  frog's  mouth.  3.  Ciliated  epithelium 
particle  from  inner  surface  of  human  membrana  tympani.  4.  Ditto,  ditto  :  from  the  human  bronchial 
mucous  membrane.  5.  Leucophrys  patula,  a  polygastric  infusory  animalcule  :  to  show  its  surface 
covered  with  cilia,  and  the  mouth  surrounded  by  them. 

to  be  entirely  independent  of  muscular  motion,  as  the  removal  of  the 
brain  and  spinal  marrow  in  frogs  does  not  affect  it,  neither  does  the 
administration  of  hydrocyanic  acid,  opium,  strychnine,  belladonna,  or 
electricity. 

This  phenomenon  exists  to  a  great  extent  in  the  animal  kingdom. 
In  man  it  has  been  observed  upon  the  surface  of  the  ventricles  of  the 
brain  and  upon  the  choroid  plexus ;  upon  the  Schneiderian  membrane, 
the  soft  palate,  the  pharynx,  the  Eustachian  tube,  extending  to  the 
cavity  of  the  tympanum,  upon  the  lining  membrane  of  the  frontal 
sphenoidal  and  maxillary  sinuses ;  upon  the  lachrymal  passages,  upon 

1  Muller's  Physiol.  p.  859. 

2  Todd  and  Bowman,  Physiol.  Anat.  p.  62,  London,  1843. 


UNION  OF  CELLS.  71 

the  lining  membrane  of  the  larynx,  trachea,  and  bronchial  tubes,  and 
upon  the  lining  membrane  of  the  uterus  and  of  the  Fallopian  tubes. 

To  resume,  in  regard  to  the  metamorphoses  of  cells  ;  they  have  a 
faculty  of  thickening  their  own  walls,  which  is  very  perceptible  in  the 
cylindrical  epithelial  cells  of  the  intestinal  canal,  and  in  the  cells  of 
cartilage.  Such  cells  as  are  thickened  by  a  deposit  of  internal  strati- 
fications present  a  striated  appearance  in  their  progress ;  and,  in  cer- 
tain cases,  the  cell  is  entirely  filled,  becomes  flattened  and  solid,  and 
all  distinction  is  lost  between  its  parts,  as  occurs  in  the  upper  layers  of 
the  epithelium.  (See  Fig.  3.) 

Another  phenomenon  attending  the  life  of  cells  is  their  rupture  or 
dehiscence  and  final  disappearance.  The  corpuscles  of  the  lymph  and 
of  blood  are  considered  as  examples  of  this.  In  the  blood-disk  upon 
the  absorption  of  its  nucleus,  the  investing  membrane  thins  down,  is 
more  easily  destroyed  by  chemical  agents  as  it  grows  older,  and  finally 
ends  by  being  dissolved  wholly.  The  cells  of  glands,  commonly  called 
mucous  granulations  when  they  are  evacuated  whole,  undergo  the  same 
process  naturally.  The  dehiscence  or  partial  destruction  of  cells  makes 
them  enter  into  free  communication  with  other  cells,  or  with  the  sur- 
face of  the  body,  or  with  the  cavities ;  being  excretory  ducts  or  other- 
wise, with  which  they  are  connected.  It  is  said  that  such  a  dehiscence 
gives  to  the  peripheral  ends  or  origins  of  excretory  ducts,  as  in  the 
salivary  glands  and  mammae,  their  globular  termination. 

Cells  are  blended  with  contiguous  ones  by  several  modes  of  union. 
In  one  mode,  their  walls  being  thickened  as  explained  above,  they  coa- 
lesce with  adjoining  cells  similarly  circumstanced,  and  with  the  inter- 
cellular substance,  the  cytoblastema :  the  cavities  of  the  cells  remaining 
all  the  time  separate.  Henle  thinks  it  to  be  on  this  principle  that 
ossific  cartilages  are  developed ;  consequently,  the  bones  themselves 
and  the  cement  of  the  teeth. 

In  another  mode  of  union,  the  cavities  of  the  cells  communicate  freely, 
in  consequence  of  the  removal  of  their  parietes  where  they  come  into 
contact.  In  some  instances,  they  make  a  continuous  tube  in  that  way, ' 
from  several  of  them  being  in  the  same  line.  In  other  instances,  they 
are  so  grouped  as  to  form  a  cluster  of  communicating  cells.  In  other  in- 
stances still,  they  are  branched  so  as  to  make  radiating  communications. 

Fig.  6. 


I 


Development  of  new  cells  from  the  outer  wall  of  pre-existing  cells. 


72  HISTOGENY. 

There  are  several  points  of  a  very  minute  character  connected  with 
the  development  and  transition  stages  of  cells,  and  of  their  nuclei  into 
tissues  :  such  as  their  fusion  with  each  other,  their  metamorphoses  by 
the  reception  of  the  ingredients  or  organisms  of  the  tissues  respectively, 
and  also  their  evolution  into  filaments  and  canals.  The  details  cannot 
be  very  conveniently  introduced  on  the  present  occasion,  but  they  are 
subjects  of  deep  interest  and  curiosity  ;  for  an  exposition  of  which  see 
the  General  Anatomy  of  the  Tissues  under  their  respective  heads,  and 
also  the  same  by  that  very  careful  and  distinguished  observer,  Professor 
Henle,  in  his  work  on  the  History  of  the  Tissues.1 

The  foregoing  observations  on  the  primordial  cells  of  the  human  body 
have  their  value  established  by  the  circumstance  that  the  nutrition  of 
a  part  consists  in  the  growth  of  individual  cells.  The  latter  derive  their 
nutriment  from  the  organic  compounds  supplied  by  the  blood,  each  set 
of  cells  making  its  selection  upon  the  principle  of  a  special  affinity  for 
some  particular  constituent  of  that  fluid.  Every  cell  is,  therefore,  to  be 
considered  as  participating  in  the  phenomena  of  life  and  of  organization, 
by  the  influence  which  it  exercises  in  its  place.  The  modification  of 
vital  force,  or  the  character  precisely  of  that  force,  constitutes  the  pro- 
blem of  life,  which,  in  the  present  state  of  the  human  mind,  must  be 
inexplicable.  It  is,  indeed,  an  ultimate  fact  of  Physiology,  of  an  in- 
scrutable character,  an  endowment  of  matter  too  subtle  for  human  in- 
vestigation. 

1  Encycl.  Anat.  Paris,  1 843 


SPECIAL 

ANATOMY  AND  HISTOLOGY. 


BOOK  I. 
PART  I. 

OF  THE  SKELETON. 

THE  skeleton  is  the  bony  framework  of  the  human  body  ;  and,  by  its 
hardness  and  form,  retains  in  proper  shape  the  whole  fabric ;  affords 
points  for  the  attachment  of  muscles,  and  protects  many  of  the  viscera. 
Anatomists  call  the  bones,  along  with  their  natural  connections  of  liga- 
ments, cartilages,  and  synovia!  membranes,  a  natural  skeleton ;  and 
the  bones  only,  but  kept  together  by  artificial  means,  an  artificial 
skeleton. 

The  bones  are  inflexible,  and  in  a  recent  state  are  of  a  dull  white 
color,  familiar  to  most  persons  from  its  being  the  same  in  animals ; 
but  they  are  made  of  an  ivory  whiteness  by  being  properly  macerated 
and  prepared. 

The  regional  division  of  the  skeleton  is  into  Head,  Trunk,  Superior 
or  Thoracic,  and  Inferior  or  Abdominal  Extremities. 

If  a  vertical  plane  be  passed  from  the  top  of  the  head  downwards, 
through  the  middle  of  the  skeleton,  this  plane  will  divide  the  latter  into 
bilateral,  or  two  equal  portions,  called,  in  common  language,  the  right 
and  the  left  side  of  the  body.  These  two  sides  are  perfectly  alike  in 
shape  and  size.1  Some  of  the  bones  are  found  in  this  plane,  being  in- 

1  The  exact  harmony  or  symmetry  of  form  and  size,  between  the  two  sides  of  the  body, 
as  a  general  rule,  is  rather  hypothetical  than  real  in  nature.  It  is  a  point  of  general  notoriety, 
that  the  right  side  enjoys  more  force  than  the  left,  and  this  will  be  found  attended  with 
greater  development.  There  are  few  persons  that  have  not  the  face  and  the  spine  some- 
what out  of  shape  from  the  bones  on  one  side  growing  larger  than  on  the  other,  the  right, 
commonly,  prevailing  over  the  left:  hence  we  see  a  nose  somewhat  turned;  and  a  spine 
curved,  the  convexity  of  which  is  to  the  right  side,  with  the  attendant  consequences,  on  the 
position  of  the  ribs,  the  scapulae,  and  the  sternum.  This  condition  of  false  growth  is  exhi- 
bited in  all  degrees,  from  a  deviation  almost  imperceptible  to  one  amounting  to  deformity. 
The  left  side  is  said,  also,  to  be  more  liable  to  diseases.  Copious  reports  on  these  several 
subjects  as  well  as  on  human  stature,  generally,  at  all  ages,  have  been  made  by  the  French 
Anatomists;  for  a  summary  exposition  of  which,  see  Malgaigne,  Anat.  Chirurg.  vol.  i.  chap. 
1.  Paris,  1838. 


74  SKELETON. 

tersected  by  it  into  two  equal  parts  or  halves :  others  are  somewhat 
removed  from  it,  and  are  in  pairs.  This  arrangement  antagonizes  the 
two  sides  of  the  body,  and  qualifies  it  for  all  its  motions. 


CHAPTER  I. 
HISTOLOGY  OF  THE  BONES. 
SECT.  I. — NUMBER,  TEXTURE. 

THE  number  of  the  bones  is  commonly  the  same  in  every  person  of 
middle  age  ;  but  they  are  less  numerous  then  than  in  infancy,  from 
several  of  them  having  been  originally  formed  in  pieces  which  coalesced 
afterwards.  The  farther  fusion,  in  advanced  life,  of  contiguous  bones 
into  each  other,  diminishes  still  more  their  number. 

The  situation  of  the  bones  varies ;  some  are  profound,  while  others 
approach  very  near  to  the  surface  of  the  body.  They  are,  as  stated, 
either  symmetrical,  that  is,  consist  of  two  lateral  portions  precisely 
alike ; — or  else  in  pairs,  having  a  perfect  correspondence  with  each  other. 
The  symmetrical  or  bilateral  bones  are  the  frontal,  the  occipital,  the 
sphenoidal,  the  ethmoidal,  the  vomer,  the  inferior  maxillary,  the  hyoid, 
the  spinal,  and  the  sternal :  and  they  are  situated  under  the  middle  ver- 
tical plane  of  the  body.  The  pairs  are  on  the  sides  of  the  middle  plane, 
more  or  less  removed  from  it. 

Bones  are  designated  as  the  Long,  the  Broad,  and  the  Thick.  The 
Long  bones  (ossa  longa)  are  those  whose  length  prevails  in  great  excess 
over  their  breadth ;  they  are  generally  cylindrical  or  prismatic,  and  have 
their  extremities  enlarged  for  the  purpose  of  articulating  with  adjoining 
bones.  The  Broad  bones  (ossa  lata)  are  those  whose  breadth  and  length 
prevail  largely  over  their  thickness ;  they  have  their  shapes  diversified 
by  muscular  connection  and  by  the  forms  of  the  viscera  they  contain. 
The  Thick  bones  (ossa  crassa)  are  such  as  have  their  several  lines  of 
measurement  more  nearly  of  a  length ;  they  are  situated  in  the  verte- 
bral column,  and  in  the  hands  and  feet,  and  have  their  surfaces  very 
irregular. 

The  bones  present,  on  their  periphery,  eminences  and  cavities,  a 
roper  knowledge  of  which  is  of  the  greatest  importance  to  the  surgeon. 
"he  former  are  called  apophyses  or  processes,  and  are  extremely  nume- 
rous and  diversified :  they  serve  for  the  origin  and  insertion  of  muscles  ; 
and  for  furnishing  articular  faces.  The  cavities  are  also  numerous ; 
some  of  them  are  superficial,  and  serve  for  articular  surfaces ;  others 
for  the  origin  of  muscles  ;  for  the  enlargement  of  other  cavities,  as  those 
of  the  nose  and  ear ;  and  for  purposes  which  will  be  mentioned  else- 
where. 

The  articular  ends  of  the  long  bones  are  called  Epiphyses,  from  their 
being  formed  from  distinct  points  of  ossification,  whereas,  the  shaft  of 


PT 


TEXTURE  OF  BONES. 


75 


the  bone  is  its  Diaphysis  or  body,  being  the  part  first 
formed.  The  epiphysis,  therefore,  as  its  name  implies, 
grows  upon  the  other.  Many  processes  grow  after  the 
manner  of  epiphyses,  from  distinct  points  of  ossifica- 
tion, though  they  are  seldom  called  by  the  same  appel- 
lation. This  is  the  case  with  the  trochanters  of  the  os 
femoris,  with  the  processes  of  the  vertebrae,  the  crista 
of  the  ilium,  and  the  tuber  of  the  ischium. 

Near  the  centre  of  many  bones,  especially  the  long, 
a  canal  is  formed  which  passes  in  an  oblique  direction, 
and  transmits  blood-vessels  to  their  interior.  There 
are  also,  at  the  extremities  of  the  long  bones,  at  the 
different  points  of  the  thick  ones,  and  near  the  margins 
of  the  flat  ones,  a  great  many  large  orifices,  which  prin- 
cipally transmit  veins  :  in  addition  to  which,  a  minute 
inspection  of  any  bone  whatever,  will  show  its  whole 
surface  studded  with  still  smaller  foramina,  also  for  the 
purpose  of  transmitting  both  kinds  of  blood-vessels. 

The  density  of  bones  is  always  well  marked,  and 
exceeds  much  that  of  other  parts  of  the  body.  It  is, 
however,  variable  in  different  bones,  and  in  different 
places  of  the  same  bone  ;  hence  their  substance  has 


Fig.  7. 


A  young  femur, 
showing,  at  1,  2,  3, 
5,  the  Epiphyses.  4. 
The  Diaphysis.  2,3 

been  divided  into  compact  or  cortical,  and  the  cellu-    Ipop^yses.  b' 
lar,  of  which  the  former  is  external  and  the- latter 
internal. 

The    Compact  structure,  or   substance,  is  formed  of  filaments  and 
laminae,  which  we  find  to  be  so  closely  in  contact  with  each  othera  that 

Fig.  8. 


The  texture  of  a  bone  as  shown  in  a  Femur,  after  maceration  in  dilute  acid.  I,  1.  The  com- 
pact matter  as  usually  seen.  2,  2.  The  same  split,  so  as  to  show  the  longitudinal  fibres  composing  it. 
3.  The  internal  cellular  matter.  4.  The  bone  seen  under  its  articular  cartilage. 

the  intervals  between  them  are  merely  microscopical  in  the  greater  part 
of  their  extent :  they  become,  however,  more  and  more  distinct,  and 


76  SKELETON. 

larger,  near  the  internal  surface.  At  the  extremities  of  the  long  bones, 
the  compact  tissue  is  gradually  blended  with  the  cellular  structure, 
or  lost  in  it.  Its  filaments  are  generally  longitudinal  in  the  cylin- 
drical bones,  radiate  from  the  centres  of  the  flat  ones,  and  are  so  blended 

Fig.  9. 


The  filaments  of   the  external   surface  of  the  compact  structure  of  an  os  femoris  treated   by 
maceration  in  diluted  muriatic  acid,  showing  very  minutely  their  course  and  general  arrangement. 

as  to  render  it  impossible  to  trace  them  in  the  thick  ones.  This  dispo- 
sition in  the  flat  bones  is  much  better  seen  in  early  life :  subsequently, 
it  becomes  indistinct. 

The  Cellular  structure,  or  substance,  grows  from  the  internal  surface 
of  the  other,  and  is  composed  of  filaments  and  small  laminae,  which  pass 
in  every  direction,  by  crossing,  uniting,  and  separating.  The  cells, 
resulting  from  this  arrangement,  present  a  great  diversity  of  form, 
size,  and  completion.  They  are  filled  with  marrow,  being  hence  called 
medullary  cells,  and  communicate  very  freely  with  each  other.  The 
latter  may  be  proved  in  the  boiled  bone,  by  the  practicability  of  filling 
them  all  with  quicksilver  from  any  given  point ;  and,  indeed,  by  the 
injection  of  any  matter  sufficiently  fluid  to  run.  The  communications 
between  them  are  formed  by  deficiencies  in  their  parietes,  after  the 
same  manner  that  the  cells  of  sponge  open  into  each  other.  This  struc- 
ture does  not  exist  in  the  earliest  periods  of  ossification,  when  the  bones 
are  cartilaginous  almost  entirely,  but  develops  itself  during  the  deposit 
of  calcareous  matter.  The  manner  of  its  formation  is  imperfectly 
understood,  though  it  may  possibly  be  the  result  of  absorption,  and  it 
is  not  completed  in  the  bones,  originally  consisting  of  several  pieces, 
till  these  are  consolidated  into  one. 

The  compact  or  cortical  and  the  cellular  structure  present  themselves 
under  different  circumstances  in  the  three  species  of  bones.  The  com- 
pact has  a  predominant  thickness  in  the  bodies  or  diaphyses  of  the  long 
bones,  and  is  accumulated  in  quantities  -  particularly  great  in  their 


TEXTURE  OF  BONES. 


7T 


middle,  which,  from  its  position,  is  more  exposed  than  their  extremities 
to  fracture  from  falls,  blows,  and  violent  muscular  efforts.  But  as  this 
texture  approaches  ,the  extremities  of  the  long  bones,  it  is  reduced  to  a 
very  thin  lamina,  merely  sufficient  to  enclose  the  cellular  structure  and 
to  furnish  a  smooth  articular  face  for  the  joints.  The  cellular  structure, 
on  the  contrary,  in  the  long  bones,  is  most  abundant  in  their  extremi- 
ties, constituting  their  bulk  there,  and  is  least  so  in  their  bodies.  It  is 
so  scattered  at  the  latter  place  as  to  leave  a  cylindrical  canal  in  their 
middle,  almost  uninterrupted  for  some  inches.  This  canal,  cellular  in  its 
periphery,  has  its  more  interior  parts  traversed  in  every  direction  by 
an  extremely  delicate  filamentous  bony  matter,  which,  from  the  fine- 
ness of  its  threads  and  the  wide  intervals  between  them,  has  been, 
not  unaptly,  compared  to  the  meshes  of  a  net,  and  is,  therefore,  spoken 
of  especially  under  the  name  of  the  reticulated  or  cancellated  structure 

Fig.  10. 


A  longitudinal  section  of  a  Tibia,  showing,  1.  The  compact  structure.  2.  The  reticulated  or  cellular 
structure.  3.  A  transverse  section  of  the  femur,  showing  its  compact  substance,  its  internal  cel- 
lular structure,  and  the  medullary  canal. 

or  tissue  of  the  bones,  in  contradistinction  to  the  cellular.  It  is  formed 
on  the  same  principle  with  the  latter ;  and  though  the  term,  from  that 
circumstance,  has  been  rejected,  upon  high  authority,  as  superfluous, 
it  appears  worthy  of  retention,  as  it  expresses  a  fact  of  some  import- 
ance. Too  weak  to  contribute  in  an  appreciable  degree  to  the  strength 
of  the  bone,  the  reticulated  or  cancellated  tissue  seems  principally 
useful  in  supporting  the  marrow  and  in  giving  attachment  to  its  mem- 
brane. The  extremities  of  this  cylindrical  canal  gradually  disappear 
by  becoming  more  and  more  cellular. 

In  the  flat  bones,  the  compact  structure  forms  only  their  surface  or 
periphery,  and  is  of  inconsiderable  but  generally  uniform  thickness ; 
the  space  within  is  filled  up  with  the  cellular  structure,  which  is  rather 
more  laminated  than  it  is  in  the  long  bones. 


78 


SKELETON. 


In  the  thick  bones,  the  compact  structure  forms  their  periphery  also  ; 
but,  generally,  it  is  thinner  than  in  the  flat :  their  interior  is  likewise 
filled  up  by  the  cellular  structure,  and  does  not  present  differences  of 
importance^  from  the  ends  of  the  long  bones. 

The  lamellated  state  of  bone  is  rendered  more  evident  under  the  use 
of  the  microscope.  In  the  long  bones  this  lamellated  structure  is  con- 
Fig.  11. 


A  view  of  the  Concentric  Lamellae  of  the  compact  matter  of  a  bone. 

centric  in  circles ;  but  in  the  flat  there  is  simply  a  superposition  in 
parallel  plates. 

Where  articular  surfaces  exist,  the  compact  structure  is  particularly 
condensed  and  smooth,  has  no  foramina  for  the  transmission  of  blood- 
vessels, and  is  strictly  adapted  to  the  adhesion  of  the  articular  cartilage. 

The  compact  tissue,  particularly  in  the  cylindrical  bones,  has  in  it  a 
multitude  of  longitudinal  canals,  visible  to  the  microscope,  and  some 


Longitudinal  section  of  compact  substance  showing  Haversian  canals  magnified. 


TEXTURE  OF  BONES.  79 

of  them  to  the  naked  eye,  which  contain  vessels  and  medullary  matter. 
These  canals,  originally  described  by  Clopton  Havers,1  run  parallel 
with  one  another  in  the  spaces  between  the  laminae,  and  give  off  small 
branches  which  pass  through  one  or  more  laminae,  and  anastomose  with 
contiguous  Haversian  canals,  thus  forming  a  reticulated  communication 
of  osseous  tubes  which  permeate  the  compact  substance.  They  open 
externally  and  receive  their  blood-vessels  from  the  periosteum,  and 
internally  merge  into  the  cells  of  the  cellular  structure,  from  whose 
medullary  membrane  they  likewise  receive  blood-vessels.  Some  of 
them  are  as  large  as  the  ^Jo^  °f  an  English  inch,  others  as  small  as 
j^njjth,  and  they  are  about  yi^th  of  an  inch  apart.  They  are,  according 
to  M.  Beclard,  about  one-twentieth  of  a  line  in  diameter,  on  an  average ; 
but  are,  generally,  larger  near  the  interior  than  the  exterior  surface 
of  the  bones,  and  have  frequent  lateral  communications  with  the  cel- 
lular structure,  and  with  the  external  surface. 

The  Haversian  canals  being  common  to  all  bones,  are  uniformly 
formed  of  concentric  circular  laminae.  They  are  in  fact  miniature  or 
extremely  attenuated  representations  of  what  the  great  medullary  canal 
is  in  the  long  bones,  and  seem  to  execute  very  much  the  same  function 
in  the  accommodation  of  blood-vessels  and  fat.  With  their  correspond- 
ing concentric  laminae  each  one  is  therefore  a  miniature,  or  subordinate 
bone,  which  for  the  advantage  of  a  name  may  be  called  the  Haversian 
Ossicle.  As  these  vascular  channels  are  very  numerous,  they  therefore 
form  a  very  fine  net-work  of  canals  in  the  midst  of  the  compact  sub- 
stance. The  arteries  and  veins  which  occupy  them  are  disposed  to 
keep  apart,  each  set  of  vessels  having  its  own  canals  ;  at  least  this  is 
to  a  considerable  extent  the  case,  a  very  strong  example  of  which  is 
seen  in  the  venous  diploic  sinuses  of  the  bones  of  the  head,  and  in  the 
bodies  of  the  vertebrae.  The  interior  of  a  Haversian  canal  is  lined  by 
a  layer  of  compact  substance,  and  exterior  to  this  layer  is  the  concen- 
tric series  of  other  layers  in  a  variable  number,  from  four  to  twelve  or 
more,  according  to  Henle2  and  others.  The  concentric  condition  is, 
however,  not  absolute,  as  the  layers  run  here  and  there  into  one  another, 
owing  to  the  arrangement  of  the  corpuscles  of  Purkinje.  From  the 
great  number  of  the  longitudinal  Haversian  canals,  a  long  bone,  when 
tested  by  a  microscope,  seems  to  be  formed  in  its  compact  texture  almost 
wholly  by  them,  so  that  it  is  really  a  fascis  or  bundle  of  the  little  stems, 
or  ossicles  forming  the  Haversian  system,  comparable  to  a  bunch  made 
of  the  barrels  of  quills. 

The  cancellated  and  the  cellular  structure  are  themselves  a  more 
expanded  development  of  the  same  arrangement. 

Microscopic  excavations  of  a  different  description,  and  called  Cal- 
cigerous,  also  exist  in  bones.  They  are  brought  into  view  by  examining 
a  transverse  section  of  bone  ground  extremely  thin  and  then  polished. 
They  consist  in  cells  (Corpuscula  Purkinje)  from  which  radiate  in  every 
direction  exceedingly  fine  tubules  (Tubuli  Calcigeri,  or  Calciphori), 
which  again  send  out  branches,  to  anastomose  with  corresponding 
branches  of  similar  adjoining  cells.  The  term  calcigerous  was  applied 
to  this  system  from  the  belief  that  the  calcareous  matter  of  bones  is 

1  Osteolo^ia  Nova,  An.  1729. 

2  Histoire  des  Tissues,  tome  ii.  p.  397. 


80 


SKELETON. 


deposited  in  them.1  Under  a  microscope  which  magnifies  from  two  to 
three  hundred  diameters,  some  very  fine  striae,  like  the  radii  of  a  circle, 
are  seen  in  great  numbers  diverging  in  straight  lines  from  the  circum- 
ference of  the  Haversian  canals  to  the  circumference  of  the  little  cylin- 
ders of  bone  forming  them,  protruding  through  and  through  their 
laminae.  They  are  called  the  canals  of  Deutsch,  but  are  considered  as 
identical  with  the  corpuscles  of  Purkinje  and  their  calcigerous  tubes, 
the  appearance  of  being  distinct  from  them  proving  delusive. 

The  Corpuscles  of  Purkinje  and  their  stellate  branches  are  now 
viewed  by  anatomists  as  a  very  beautiful  arrangement  of  small  lenticu- 
lar or  flattened  oval  excavations,  in  great  numbers,  with  their  radiating 
tubules  anastomosing  with  those  of  adjacent  similar  excavations.  A 

Fig.  13. 


Section  of  a  human  femur,  about  its  middle,  exhibiting  the  ends  of  the  Haversian  canals,  and  their 
relation  to  each  other,  also  now  each  one  is  surrounded  by  its  series  of  concentric  lamellae  making  the 
ossicle  of  Havers.  This  laminated  condition  is  well  shown  by  polarized  light,  which  causes  the 
corpuscles  to  disappear,  and  the  laminae  to  be  well  defined. 

granular  matter  is  found  within  them  and  their  branches.  The  tubules 
take  their  origin  from  the  interior  of  the  Haversian  canals,  according 
to  Mr.  Tomes,2  and  pass  in  series  between  the  canals,  connecting  them 
one  with  another.  They  then  reach  the  surface  of  the  bone,  and 
end  on  it  by  open  orifices,  or  are  reflected  back  into  the  tissue  of  the 
bone,  to  enter  the  tubules  adjoining. 

The  proof  of  this  system  being  permeable  is  that,  if  a  dry  section  of 
bone  in  which  they  are  very  visible,  be  touched  with  a  drop  of  oil  of 

1  The  corpuscles  of  Purkinje,  called  after  their  discoverer,  are  among  the  most  perma- 
nent of  the  anatomical  traits  of  bone,  notwithstanding  their  extreme  minuteness.     In  the 
petrified  vertebra  of  a  Zeuglodon  (whose  remains  abound  in   the   limestone  of  Alabama) 
sent  to  me  by  Dr.  Alonzo  B.  C.  Dossey,  the  corpuscles  were  exhibited  in  great  abundance 
and  very  distinctly  with  the  microscope,  by  Dr.  Joseph  Leidy.    This  race  of  animals,  having 
a  length  of  about  seventy  feet,  has  been  named  by  Professor  Owen  from  the  transverse  sec- 
tion of  the  teeth  being  in  some  degree  a  resemblance  to  the  outline  of  an  hour-glass;  and  is 
considered  as  cetaceous  by  him  instead  of  saurian,  as  originally  suggested  by  Dr.  Harlan. 
Being  found  uniformly  in  the  fossilized  state,  its  antiquity  defies  human  computation. 

2  See  Physiolog.  Anat.  Todd  and  Bowman,  p.  109. 


TEXTURE  OF  BONES.  81 

turpentine,  this  fluid  will  penetrate  quickly  into  the  Haversian  canals, 
from  thence  into  the  stellate  tubules,  thence  into  the  lenticular  excava- 
tions ;  thence  through  the  tubules  on  the  other  side,  and  so  on  from  one 
set  to  another  till  all  be  filled.  When  air  has  pre-occupied  these  spaces, 
and  the  turpentine  can  not  displace  it,  the  bubbles  are  very  apparent. 

These  lacunae,  or  corpuscles  of  Purkinje,  have  their  flat  sides  for  the 
most  part  in  line  with  the  nearest  surface  of  bone.  They  have  an  ave- 
rage length  of  Ts^nj^h  °^  an  incn>  are  about  half  as  wide,  and  one-third  as 
thick.  The  radiating  tubules  are  from  2  o  Jfit>tn  to  TsifiT^h  °f  an  incn  i*1 
diameter.  Each  class  of  animals  has,  according  to  Mr.  Queckett,  its 
characteristic  lacunae. 

The  preceding  exposition  of  the  texture  of  bones  may  be  summed  up 
in  the  example  of  a  long  bone,  which  is,  in  itself,  a  good  specimen  of  the 
arrangement  everywhere  else  to  be  met  with,  under  some  modifications. 
Upon  the  exterior  periphery  of  the  bone  we  see  the  surface  occupied 
with  an  immense  number  of  foramina  for  the  transmission  of  vessels : 
upon  the  interior  formed  by  the  medullary  canal,  and  the  areolar  struc- 
ture, we  have  also  great  numbers  of  orifices  showing  the  vascular  con- 
nection of  the  medullary  membrane,  and,  finally,  in  the  intermediate 
compact  structure,  we  have  the  bone  made  cribriform  by  the  numerous 
microscopic  channels  of  the  Haversian  canals;  and  the  lacunae  and 
tubules  of  the  Purkinjean  system.  It  is  estimated  that  these  develop- 
ments of  surface  bring  every  point  of  bone  within  a  small  distance, 
T^th  of  an  inch,  from  a  blood-vessel. 

Bones  exhibit  a  superficial  layer  obtained  directly  from  the  external 
periosteum.  A  similar  layer  is  derived  from  the  medullary  membrane, 
and  forms  the  areolar  structure.  These  two  layers  send  out  the  compact 
osseous  lining  of  the  Haversian  canals.  As  the  lacunae  or  corpuscles  of 
Purkinje  are  everywhere  in  the  bone,  their  planes  change  their  direc- 
tions, so  as  to  observe  that  of  the  adjoining  Haversian  canals  and  ossi- 
cles, whether  they  be  longitudinal,  transverse,  or  oblique. 

The  radiating  canals  of  Deutsch,  which  are  like  fine  lines  or  filaments 
drawn  from  the  Haversian  canal  of  an  ossicle  to  the  outer  circumference 
of  the  latter,  are  formed  by  a  linear  series  of  lacunae,  the  longer  diame- 
ters of  which  face  inwards  and  outwards,  and  inosculate  with  those  in 
the  same  line  centrally  and  peripherally.  Each  lamina  of  the  ossicle 
is  thus  rendered  porous;  and  the  ossicle  may,  as  observed,  be  described 
as  a  bone  of  itself,  having  for  its  centre  a  Haversian  canal,  containing 
a  blood-vessel.  As  the  corpuscles  of  Purkinje,  and  the  radiating  tubes 
of  Deutsch  communicate  reciprocally  by  being  in  fact  the  same  system, 
and  connect  also  with  the  canal  of  Havers,  so  every  bone  is  formed 
largely  of  these  systems  of  anastomosing  tubes ;  the  larger  of  which 
to  wit,  the  Haversian  only,  conduct  blood-vessels,  while  the  other,  being 
too  fine  for  that  purpose,  transmit  merely  the  nourishing  juices  of  the 
bone  (the  sap,  we  may  say),  derived  from  the  blood.  This  arrangement 
of  bone  into  canals  compensates  for  its  want  of  bibulous  properties  like 
cartilage,  and  the  softer  substances  of  the  human  body ;  and  thereby 
secures  to  it  an  adequate  degree  of  nourishment. 

As  every  round  bone  is  thus  formed  from  a  fascis  of  Haversian  cylin- 
ders or  ossicles,  so  the  latter  are  held  in  groups  by  a  cylinder  of  bone 
exterior  to  them  all,  and  by  another  cylinder  which  is  within,  it  being 
VOL.  I — 6 


82 


SKELETON. 


contiguous  to  the  medullary  cavity  of  the  bone.  The  spaces  existing 
between  the  contiguous  Haversian  ossicles  are  filled  up  by  concentric 
lamellae  of  bone,  running  in  line  with  those  of  the  external  and  internal 
cylinders. 

From  the  researches  of  Mr.  Tomes,1  it  appears  that  the  ultimate  struc- 
ture of  bone  is  granular.  This  arrangement  is  manifested  both  by  cal- 
cination and  by  steeping  in  an  acid.  These  granules  are  intermixed 
with  the  osseous  lacunae  called  the  corpuscles  of  Purkinje. 

If  a  thin  natural  plate  of  bone,  as,  for  example,  a  fragment  of  ethmoid, 
be  examined  microscopically,  it  is  found  not  penetrated  by  blood-vessels, 
but  is  nourished  simply  from  its  surface  by  the  vascular  periosteum 
there.  Tested  by  prolonged  boiling,  so  as  to  remove  largely  the  animal 
matter,  it  is  seen  to  consist  of  granules  of  osseous  or  calcareous  matter, 
varying  in  size  from  the  j^^thto  the  e  oJoT)tn  °f  an  inch.  A  piece  of  this 
description  exhibits  the  osseous  tissue  in  its  simplest  state,  and  is  dotted 

Fig.  14. 


Purkinjean  Corpuscles  magnified  500  diameters. — a.  Central  cavity,    b.  Its  ramifications. 

abundantly  with  the  Purkinjean  corpuscles  sending  out  their  stellated 
arms,  which  anastomose  freely  with  others.  The  minute  granular  matter 
filling  the  corpuscles  is  thought  to  have  the  faculty  of  drawing  the  nu- 
tritive materials  of  the  adjoining  blood-vessels,  by  the  intervention  of  a 
set  of  minute  cells  contiguous  to  the  osseous  tissue.  A  scale  of  some 
fish,  as  the  Lepidosteus,2  which  has  no  blood-vessels  in  it,  exhibits  a 
strong  analogy  with  this  arrangement  in  the  human  bone,  there  being 
an  intertexture  of  canals  like  a  net-work.  The  plates  forming  the  can- 
Fig.  15. 


Section  of  a  bony  scale  of  the  Lepidosteus. — a.  Showing  the  regular  distribution  of  the  lacunae  and 
of  the  connecting  canaliculi.    b.  Small  portion  more  highly  magnified. 

cellated  structure  of  the  thicker  bones  repeat  the  same  exhibition,  the 
nutritive  matter  being  attracted  into  their  substance  from  the  vascular 
membrane  covering  them. 

1  Physiol.  Anat.  &c.,  by  Todd  and  Bowman,  p.  108,  London,  1843. 

2  Carpenter,  Elements  of  Physiology,  &c.,  Phila.  1846. 


TEXTURE  OF  BOXES.  83 

A  simple  experiment  on  any  of  the  cylindrical  bones  will  prove  that 
the 'tumefaction  of  their  extremities  does  not  add  proportionately  to 
their  weight,  as  one  inch  or  any  other  given  section  of  the  compact 
part  wreighs  very  nearly  the  same  with  a  section  of  equal  length  from 
the  cellular  extremities.  This  swelling  at  the  ends  of  the  bones  adds 
much  to  the  safety  of  their  articular  union,  as  the  extent  of  the  sur- 
faces is  thereby  much  increased,  and,  consequently,  they  are  less  liable 
to  displacement.  The  cylindrical  and  the  cellular  cavities,  thus  formed 
in  the  long  bones,  by  increasing  the  volume  of  the  latter,  add  greatly  to 
their  strength  beyond  what  would  have  occurred,  had  the  same  weight 
of  material  been  solid.  The  late  Dr.  P.  S.  Physick  instituted  a  demon- 
stration of  this  most  satisfactorily  by  a  scroll  of  paper,  which,  on  being 
rolled  up  successively  into  cylinders  of  various  sizes,  has,  like  a  lever, 
its  power  of  sustaining  lateral  pressure  on  one  of  its  extremities,  con- 
tinually increased  as  its  volume  or  diameter  is  augmented,  until  the 
latter  reaches  a  certain  extent.  The  same  highly  distinguished  teacher 
also  pointed  out  another  very  important  advantage  of  the  cellular  struc- 
ture. It  is  that  of  serving  to  diminish,  and  in  many  cases  to  prevent 
concussion  of  the  brain,  and  of  the  other  viscera,  in  falls  and  in  blows. 
The  opinion  was  verified  by  his  demonstrating  the  momentum,  which 
is  communicated  through  a  series  of  five  ivory  balls  suspended  by 
threads,  when  one  of  them  is  withdrawn  from  the  others,  and  allowed 
to  impel  them  by  its  fall.  This  momentum  is  so  completely  transmitted 
through  the  series,  that  the  ball  at  the  farthest  end  is  impelled  almost 
to  the  distance  from  which  the  first  one  fell.  This  familiar  experi- 
ment, used  as  a  preliminary  test  to  the  accuracy  of  his  views,  was 
immediately  succeeded  by  his  substituting  for  the  middle  one  of  ivory, 
a  ball  made  of  the  cellular  structure  of  bone.  The  same  degree  of  im- 
pulsion now  communicated  at  one  end  of  the  series,  is  almost  lost,  or 
rather  neutralized,  in  the  meanderings  of  the  cellular  structure  of  the 
substitute ;  and  particularly  if  the  latter  be  previously  filled  with  tal- 
low or  well  soaked  in  wrater,  so  as  to  bring  it  to  a  condition  of  elasticity 
resembling  the  living  state. 

In  persons  of  advanced  age,  the  marrow  of  the  bones  becomes  more 
abundant,  and-  their  parietes  thinner;  we  also  observe  then,  that 
the  bones  break  more  readily,  and  are  more  crumbling,  rotten,  or  soft, 
than  during  the  anterior  periods  of  life.  In  women,  after  the  critical 
period  is  passed,  these  traits  are  especially  developed,  and  the  compact 
centres  of  the  long  bones  have  their  texture  more  or  less  approximated 
to  the  spongy  tissue.  Mr.  Yelpeau1  says,  that  in  the  amphitheatres  of 
Paris,  he  has  often  cut  easily  with  a  scalpel  the  ends  of  the  femur, 
tibia,  humerus,  the  bodies  of  the  vertebrae  and  the  tarsal  bones,  when 
there  was  apparently  no  morbid  lesion  in  the  skeleton :  a  similar  expe- 
rience belongs  to  most  practical  anatomists. 


SECTION  II. — COMPOSITION  OF  BOXES. 

The  bones,  under  every  modification  of  shape  and  mechanical  ar- 
rangement, are  constituted  by  precisely  the  same  elementary  matters: 

1  Ar.at.  Cbirurg. 


84  SKELETON. 

the  principal  of  which  are  an  animal  substance,  cartilage;  and  earthy 
matter,  in  intimate  combination.  Their  minute  analysis,  accord- 
ing to  Berzelius,  when  they  are  deprived  of  water  and  of  marrow, 
affords 

32  Parts  of  cartilage  or  gelatin,  completely  soluble  in  water; 

1  Of  insoluble  animal  matter; 

51  Phosphate  or  rather  subphosphate  of  lime; 
11   Carbonate  of  lime; 

2  Fluate  of  lime  ; 

1  Phosphate  of  magnesia; 
1  Soda  and  muriate  of  soda. 

There  are  some  other  ingredients  manifested  in  the  analysis  of 
Fourcroy  and  Vauquelin,  as  iron,  manganese,  silex,  alumen,  and  phos- 
phate of  ammonia.  The  relative  proportions  of  the  above  ingredients 
are  not  uniformly  the  same,  as  the  bones  of  the  cranium,  and  the 
petrous  portion  of  the  temporal  in  a  remarkable  degree,  have  more 
calcareous  matter  in  them  than  the  other  bones  of  the  same  skeleton. 
There  is  also  a  considerable  diversity  in  individuals,  according  to  their 
age  and  to  certain  morbid  affections.  Thus,  according  to  Schreger,1 
the  bones  of  a  child  have  one-half  only  of  earthy  matter,  while  those 
of  an  old  person  have  seven-eighths  of  the  entire  mass. 

The  coloring  of  the  skeleton  by  madder,  when  an  animal  is  fed  on 
it,  is  considered  a  sufficient  proof  of  the  phosphorus  and  calcium  being 
in  the  state  of  phosphate  of  lime. 

The  Earthy  matter  gives  to  bones  their  hardness  and  want  of  flexi- 
bility, and  is  easily  insulated  from  the  other  by  combustion ;  which,  in 
destroying  the  animal  part,  leaves  the  earthy  in  a  white  friable  state, 
but  preserving  the  original  form  of  the  bone.  If  the  heat  be  of  a  high 
degree,  the  calcareous  part  becomes  vitrified,  and  its  cells  are  blended 
by  fusion.  The  action  of  the  atmosphere,  long  continued,  also  divests 
the  bones  of  their  animal  matter,  and  the  calcareous  then  falls  into 
a  powder.  If  the  bones  be  kept  beneath  the  surface  of  the  ground, 
by  which  they  are  less  affected  by  changes  in  temperature  and  moist- 
ure, the  animal  matter  remains  for  an  immense  number  of  years. 
There  are  in  the  Hunterian  Museum  of  London,  preparations  of  the 
teeth  of  the  Mastodon  or  Mammoth,  in  which  the  animal  matter  is 
exhibited  entire,  notwithstanding  the  great  lapse  of  years  since  it  was 
in  a  living  state:  and  a  repetition  here  of  the  same  experiments  on  the 
teeth  and  bones  of  the  same  animal  has  exhibited  the  same  result. 
Animal  matter  has  been  detected  in  fossil  shells,  the  existence  of  which 
was  probably  anterior  to  that  of  the  human  family. 

The  phosphoric  acid  of  bones  gives  them  a  luminous  appearance  at 
night.  Bichat  says,  that  in  these  cases  he  has  found  an  oily  exuda- 
tion on  the  luminous  points,  probably  from  the  marrow  or  contiguous 
soft  parts.  This  phenomenon  will  account  for  many  of  the  supersti- 
tions which  in  all  ages  have  affected  ignorant  minds  on  the  subject  of 
burying-grounds. 

The  immersion  of  a  bone  in  diluted  muriatic  acid  is  the  best  method 

i  Mailer's  Physiol.  p.  393. 


COMPOSITION  OF  BONES.  85 

of  demonstrating  the  Animal  substance  in  a  separate  state.  The  strong 
affinity  of  the  acid  for  the  earthy  part,  and  the  soluble  nature  of  the 
salt  thus  formed,  leave  the  animal  matter  insulated.  In  this  state  it 
preserves  the  original  form  of  the  bone,  is  cartilaginous,  flexible,  and 
elastic.  The  action  of  hot  water  alone,  upon  a  bone,  by  continued 
boiling,  will,  from  the  soluble  nature  of  the  cartilage,  separate  the  lat- 
ter from  the  earthy  part,  and  convert  it  into  gelatin.  The  gelatin  may 
be  precipitated  afterwards  from  the  water,  by  tannin.  The  mode  of 
this  combination  of  animal  and  of  earthy  matter  is  not  understood,  but 
it  is  generally  supposed  to  exist  by  the  extremely  small  cavities  of  the 
former  receiving  earthy  particles,  in  the  same  way  that  a  sponge  holds 
water.1 

Miiller2  says,  that  his  investigations  have  elicited  the  remarkable 
fact  of  the  cartilage  of  bone  before  ossification,  consisting  of  chon- 
drin,  but  afterwards  of  ordinary  gelatin  :  and  that  bones  affected  with 
softening  no  longer  yield  gelatin,  but  contain  a  large  quantity  of  fatty 
matter. 

There  are  no  means  for  investigating  the  minute  texture  of  the 
bones  more  instructive  than  the-  removal  of  the  earthy  part  by  an 
acid.  The  cartilage  thus  left  is  the  complete  mould,  in  every  parti- 
cular of  form,  into  which  the  particles  of  calcareous  matter  were  de- 
posited. In  this  state,  the  compact  part  of  the  bodies  of  the  cylin- 
drical bones  may  be  separated  into  laminse  ;  and  these  laminae,  by  the 
aid  of  a  pin  or  finely-pointed  instrument,  maybe  subdivided  into  filaments 
or  threads.  (See  Figs.  9,  11.) 

When  a  very  thin  lamella  of  softened  bone  is  peeled  off  from  the 
surface,  it  presents  distinctly  a  fibrous  condition,  in  a  reticulated  state, 
and  adhering  at  the  points  of  intersection.  It  is  considered  by  Prof. 
Sharpey  as  being  unequivocal  white  fibrous  tissue.  There  is  certainly 
much  less  difference  between  the  fibre  of  bone  cartilage  and  the  white 
fibre  than  one  would  suppose  from  ordinary  examination.  For,  if  the 
upper  end  of  the  os  femoris  be  softened  in  an  acid,  with  its  capsular 
ligament  left,  it  will  be  found  very  difficult,  owing  to  the  uninterrupted 
continuity  of  the  two,  to  detect  where  the  ligamentous  fibre  ends  and 
the  cartilaginous  fibre  begins. 

The  laminae  of  round  bones,  though  enclosing  one  another,  are  not 
exactly  concentric.  I  have  observed,  that  the  more  superficial  come  off 
with  great  uniformity  and  ease  in  the  adult  bone,  but  the  intertexture  con- 
tinually increases  towards  the  centre.  Bichat  has  objected  to  this  dissec- 
tion of  the  bones,  that  the  laminge  are  not  formed  in  nature,  but  factitiously, 

1  If  we  conceive  the  phosphate  of  lime  and  the  other  earthy  materials  of  bone  to  be  in  a 
state  of  solution  in  the  blood  and  serum  with  which  the  cartilaginous  rudiment  of  the  bone 
is   impregnated,  any  action  which  would  precipitate   the   earthy  materials  would    also,  of 
course,  impregnate  the  cartilage  with  them,  and  this  process  may  be  considered  as  completed 
when  the  bone  acquires  its  proper  consistence. 

Considering  cellular  substance  as  the  parenchyma  or  primordium  of  all  other  parts,  it  is 
probably  a  speculation  not  entirely  groundless,  that  every  peculiar  tissue  or  glandular  tex- 
ture has  its  elements  precipitated  from  the  circulating  fluid  in  a  manner  analogous  to  that 
of  the  calcareous  part  of  bone.  This  idea  also  affords  a  clue  to  a  result  almost  uniform  in 
protracted  macerations  of  all  tissues,  to  wit,  the  parts  being  brought  back  to  the  primordial 
state  by  the  peculiar  deposits  in  them  being  dissolved  in  the  water  and  removed. 

2  Physiol.  p.  393. 


00  SKELETON. 

by  the  art  of  the  anatomist,  and  that  their  thickness  depends  entirely 
on  the  point  at  which  one  chooses  to  separate  them ;  they,  therefore, 
may  be  made  thick  or  thin  at  pleasure.  It  does  not  appear  to  me  diffi- 
cult to  account  for  the  manner  in  which  this  laminated  arrangement  is 
produced.  The  longitudinal  filaments  of  the  bones  adhere  with  more 
strength  to  each  other  at  their  sides  than  they  do  to  those  above  or  below, 
in  consequence  of  which  a  plane  of  these  filaments  may  be  raised  at 
any  place  and  of  any  thickness.  This  fact  does  not  involve  the  in- 
ference that  the  bones  are  originally  formed  by  a  successive  deposit 
of  one  lamina  over  another ;  it  merely  inculcates  the  mode  of  union 
between  the  filaments  or  threads.  But  that  the  periosteum  secretes 
the  external  laminae  in  the  adult  bone,  as  previously  alluded  to,  is  true, 
inasmuch  as  they  separate  with  unusual  or  peculiar  facility  from  the 
subjacent  one.  We  know  that  the  periosteum  has  the  power  of  this 
secretion,  as  a  laminated  deposit  of  bone  on  the  roots  of  the  adult 
teeth  frequently  met  with  proves,  without  doubt;  as  also  the  phenomena 
of  necrosis.  The  vascular  net-work  of  the  periosteum  is  analogous  or 
correspondent  to  that  of  the  bone,  for  which  reason  it  is  that  this  mem- 
brane is  one  of  the  tributaries  to  the  supply  of  bone  in  its  growing 
stage,  but  not  in  virtue  merely  of  its  fibrous  character.  The  history 
of  the  abnormal  formation  of  bone  in  any  one  or  all  of  the  tissues  of 
the  body,  is  also  a  proof  that  whenever  there  are  vessels  it  may  in  cer- 
tain cases  be  secreted. 

The  disposition  of  the  cylindrical  bones  to  separate  into  laminae 
is  constantly  manifested  in  such  as  are  simply  exposed  to  the  atmo- 
sphere. 

The  opinion  of  the  laminated  and  filamentous  arrangement  of  bones 
has  been  very  generally  received  by  anatomists.  Malpighi,  whose 
name  is  inseparably  connected  with  minute  investigations  in  anatomy, 
taught  it.  Gagliardi,  also,  in  admitting  it,  thought  he  saw  pins  of  dif- 
ferent forms  for  holding  the  laminae  together.  Havers  also  saw  the 
laminated  and  thread-like  structure.  In  short,  there  are  few  of  the 
older  anatomists  who  have  not  adopted  fully  the  opinion.  Among  the 
moderns,  the  late  M.  Beclard,  the  distinguished  and  able  Professor  of 
Anatomy  in  the  School  of  Medicine  in  Paris,  says,  that  when  the  earth 
is  removed  from  bones  by  an  acid,  if  they  be  softened  by  maceration 
in  water,  the  compact  substance,  which  previously  offered  no  apparent 
texture,  is  separated  into  laminae,  united  by  filaments;  the  laminae  them- 
selves, at  a  later  period,  separate  themselves  into  filaments,  which,  by 
a  further  continuation  of  the  process,  swell,  and  become  areolar  and 
soft.  A  long  bone  examined  after  this  process  divides  its  body  into 
several  laminae,  the  most  external  of  which  envelops  the  rest;  and  the 
remainder,  by  rarefying  themselves  towards  the  extremities,  are  con- 
tinuous with  the  cellular  structure  there. 

J.  F.  Meckel,  of  the  University  of  Halle,  has  furnished  the  following 
account  in  his  General  Anatomy  of  the  Bones : — 

"  The  filaments  and  the  laminae  which  constitute  the  bones  are  not 
simply  applied  one  against  the  other,  so  as  to  extend  the  whole  length, 
breadth,  or  thickness  of  a  bone,  or  to  go  from  its  centre  to  the  circum- 
ference. They  lean  in  so  many  different  ways,  one  against  another, 
and  unite  so  frequently  by  transverse  and  oblique  appendages  or  pro- 


COMPOSITION  OF  BONES.  87 

cesses,  that  some  great  anatomists,  deceived  by  this  arrangement^  have 
doubted  the  fibrous  structure  of  bones.  Nevertheless,  their  opinion  is 
not  perfectly  correct.  In  spite  of  those  inflections  and  anastomoses  of 
fibres,  the  fibrous  structure  always  remains  very  apparent,  and  one  is 
warranted  in  saying  that  the  dimension  of  length  exceeds  the  two 
others,  in  the  texture  of  many  bones.  This  predominance  is  chiefly 
well  marked  in  the  first  periods  of  osteogeny,  for,  at  a  later  time,  the 
fibres  are  so  applied  against  each  other,  as  scarcely  to  be  distinguished. 
But  these  longitudinal  fibres  never  exist  alone  ;  there  are  many  oblique 
or  transverse  ones  from  the  first  periods  of  ossification ;  and  they  are 
even  from  the  beginning  so  multiplied,  that  the  number  of  longitudinal 
fibres  does  not  prevail  over  them  so  much  as  at  a  subsequent  period, 
when  the  fibres  approach  nearer,  in  such  way  that  the  transverse  be- 
come oblique;  until  at  last,  from  the  increase  of  the  bone,  the  latter 
at  first  view  seems  to  be  composed  only  of  longitudinal  fibres.  The 
transverse  and  oblique  fibres  do  not  form  a  separate  system,  but  con- 
tinue uninterruptedly  with  the  longitudinal,  which  they  unite  to  each 
other."1 

The  venerable  Scarpa,  some  years  ago,  advanced  opinions  adverse 
to  the  laminated  and  fibrous  or  filamentous  tissue  of  bones.2  The  latter 
doctrine  he  was  induced  to  think  a  mere  mistake,  arising  from  careless 
observation.  Founding  his  own  views  upon  what  he  had  seen  in  the 
growing  bone,  in  the  adult  bone  when  its  earthy  parts  were  removed 
by  an  acid,  and  upon  certain  cases  of  disease  attended  with  inflamma- 
tion of  the  bone,  he  denied,  without  reservation,  the  existence  of  laminae 
and  fibres  in  bones,  declaring  that  even  the  hardest  of  them  were 
cellular  or  reticulated.  It  appears  to  me,  in  looking  over  his  paper, 
that  a  desire  to  overthrow  old  doctrines  and  to  establish  new  ones  has 
induced  him  to  make  one  omission  in  the  report  of  his  experiments, 
otherwise  unaccountable  in  a  man  of  his  general  intelligence  and  candor. 
Having  softened  the  cylindrical  bones  in  an  acid,  he  next  proceeds  to 
a  long-continued  maceration  of  them  ;  he  finds,  as  other  persons  have 
done,  the  animal  part  of -the  bone  finally  resolving  itself  into  a  soft 
cottony  tissue.  He  has  made  but  one  step  from  the  immersion  in  the 
acid  to  the  last  stage  of  the  process  of  maceration.  Now  if,  in  a 
short  time  after  the  bone  had  been  softened  in  the  acid,  he  had 
admitted  an  intermediate  observation,  he  would  no  doubt,  like  all  other 
inquirers,  have  found  that  the  animal  part  of  the  cylindrical  bones 
was  readily  separable  into  laminge ;  and  that,  by  a  pin  or  needle,  these 
laminae  could  be  split  into  fibres,  the  greater  part  of  which  are  lon- 
gitudinal ;  and  that  pounding  the  ends  of  these  fibres  with  a  hammer 
would  resolve  them  into  a  very  fine  penicillate  or  brush-like  structure. 
There  is  no  objection  to  the  conclusion  that  these  laminae  and  filaments, 
as  a  final  condition,  produce  a  very  fine  microscopical  cellular  arrange- 
ment, which  may  be  made  more  apparent  in  being  distended  by  the 
development  of  gaseous  substances,  arising  from  putrefaction  or  mace- 

1  Manuel  D'Anat.  Gen.  Descr.  et  Path.,  traduit  de  1'Allemand  par  Jourdan  et  Breschet. 
Paris,  1825. 

2  A.  Scarpa.     De  penitiori  ossium  structura  commentarius.     Leips.  1795.     See  also  Ana- 
tomical Investigations,  Philadelphia,  1824,  by  the  late  J.  D.  Godman,  M.  D.,  for  an  English 
translation  of  the  same. 


88  SKELETON. 

ration  ;  but  there  is  reason  for  a  decided  opposition  to  the  assertion  of 
there  being  no  fibres  in  bones  when  we  have  daily  under  our  eyes  pre- 
parations showing  them;  some  of  which  demonstrate  the  fibres  running 
principally  longitudinally,  others  spirally,  like  the  grain  of  a  twisted 
tree,  and  others  having  a  mixed  course.  Upon  the  whole,,  the  descrip- 
tion cited  from  Meckel  exhibits  this  subject  in  a  just  and  accurate 
manner. 

The  more  obvious  arrangement  of  the  cellular  and  compact  struc- 
tures of  the  bones  indicates  a  considerable  diiference  in  their  intimate 
texture:  they  are,  nevertheless,  closely  allied,  for  one  structure  is  con-, 
verted,  alternately,  into  another  by  disease — of  which  specimens  abound 
in  the  Wistar  Museum.  In  both  cases,  from  the  fibres  or  filaments 
are  formed  cells  which  exist  everywhere,  and  are  only  larger  and  more 
distinct  in  what  we  call  the  cellular  structure;  but  the  compact  part 
has  also  its  cells,  as  seen  from  the  preceding  account,  though  they  are 
smaller,  more  flattened,  and  for  the  most  part  microscopical.1 

Organization  of  B,ones. 

The  blood-vessels  of  the  bones,  though  small,  are  very  numerous. 
This  is  well  established  by  the  success  of  fine  injections,  which,  in  the 
young  bone,  communicate  a  general  tinge,  and  by  scraping  the  perios- 
teum from  living  bones,  whereby  their  surface  in  a  little  time  becomes 
covered  with  blood,  effused  from  the  ruptured  vessels.  In  those  opera- 
tions for  exfoliation  from  the  internal  surfaces  of  the  cylindrical  bones, 
where  it  is  necessary  to  excavate  the  bone  extensively  in  order  to  re- 
move all  the  detached  pieces,  unless  the  general  circulation  of  the  limb 
be  previously  arrested  by  the  tourniquet,  the  cavity  of  the  bone  is 
flooded  with  blood.  'Bichat  has  also  remarked  that  the  blood-vessels 
of  the  bones  become  unusually  turgid  and  congested  in  cases  of  drown- 
ing and  strangulation.  The  observations  in  1832,  on  cholera  in  Paris, 
showed  the  same  congestion  of  black  blood  to  have  been  produced  by 
that  disease. 

The  arteries  which  supply  the  bones,  from  their  mode  of  distribution, 
are  referred  to  three  classes.  The  most  numerous  and  the  smallest, 

1  The  intimate  structure  of  the  bones  has  been  most  carefully  explored  in  modern  times? 
and  our  knowledge  of  it  is  very  largely  due  to  observations  within  a  few  years,  as  seen. 
At  a  former  period,  Havers  had  discovered  the  small  canals  known  now  by  his  name,  and 
also  called  medullary.  Leeuwenhceck  had  described  the  calcigerous  canals  and  the  osseous 
corpuscles.*  Gragliardij'  gave  a  good  description  of  the  lamellae  and  filamentous  arrange- 
ment of  the  bones.  His  observations  were  confirmed,  and  further  illustrated,  by  those  of 
Duhamelt  and  some  others.  Malpighi  considered  the  bones  as  formed  by  a  uniform  net- 
work of  fibres§  within  the  interstices  of  which  the  calcareous  elements  were  deposited,  and 
he  rejected  the  idea  of  a  lamellated  arrangement,  except  so  far  as  it  was  artificially  produced 
by  the  manipulations  of  the  anatomist. 

In  regard  to  subsequent  opinions  on  this  point,  Scarpa,  as  just  stated, ||  rejected  the  senti- 
ment of  the  lamellated  and  fibrous  condition  of  bones,  and  asserted  that  the  bones  consisted  in 
a  reticular  cellular  tissue,  which  in  the  flat  and  thick  bones  is  perfectly  homogeneous,  the 
only  difference  between  the  spongy  and  compact  tissue  being,  that  the  latter  is  more  dense 
in  its  structure  than  the  other. 


*  Anat.  S.  Inter.  Rer.  p.  261,  1687.  f  Anat.  Oss.  p.  11,  an.  1689. 

t  Acad.  de  Paris,  from  1739  to  1743.  §  Oper.  posthuma,  p.  47,  an. 

[|  De  Penit.  Oss.  Struct.  1799. 


ORGANIZATION  OF  BONES.  89 

are  those  which  penetrate  from  the  periosteum,  by  the  capillary  pores 
found  over  the  whole  surface  of  the  bones.  *  The  next  are  those  which 
penetrate  the  larger  foramina  at  the  extremities  of  the  long  bones,  and 
at  different  points  of  the  surface  of  others,  and  the  third  class,  called 
nourishing,  amounts  to  but  one  artery  for  each  of  the  cylindrical  bones 
which  penetrates  by  an  appropriate  canal,  as  mentioned,  commonly 
near  the  centre  of  the  bone. 

The  arteries  of  the  first  two  classes  are  generally  extremely  small. 
They  ramify  upon  the  compact  and  cellular  structure,  penetrating  it  in 
every  direction.  At  death,  they  are  commonly  filled  with  blood,  which 
renders  the  injection  of  them  difficult.  The  third,  or  as  commonly 
called  the  nutritious  artery,  is  of  a  magnitude  proportioned  to  the  bone 
to  be  supplied.  Being  single  in  almost  every  instance,  it  passes 
through  the  compact  tissue,  and  having  reached  the  medullary  cavity, 
it  divides  immediately  into  two  branches ;  each  of  which,  in  diverging 
from  its  fellow,  goes  towards  its  respective  extremity  of  the  bone. 
These  branches  ramify  into  countless  capillary  vessels  upon  the  mem- 
brane containing  the  marrow,1  and  finally  terminate  by  free  anasto- 
moses with  the  extreme  branches  of  the  other  two  systems. 

The  veins  of  the  bones  are  very  abundant.  Some  are  in  company 
with  the  branches  of  the  third,  or  nutritious  arteries,  and  their  common 
trunk  goes  out  at  the  nutritious  foramen,  into  general  circulation. 
These  ramifications  have  been  long  known,  and  bring  back  the  blood 
from  the  medullary  membrane  only.  But  the  veins  which  receive  the 
blood  of  the  other  arteries  do  not  attend  them,  and  were  first  of  all 
found  in  the  diploic  structure  of  the  cranium,  which  led  to  the  dis- 
covery of  them  in  all  the  other  bones.  The  honor  of  the  original 
observation  was  claimed  respectively  by  two  very  distinguished  men  of 
Paris,  MM.  Dupuytren2  and  Chaussier.3  These  veins  issue  from  the 
bones  by  numerous  openings  distinct  from  those  furnishing  a  passage 
to  the  arteries.  This  circumstance  is  remarkably  well  seen  in  the  flat 
and  thick  bones,  and  at  the  extremities  of  the  cylindrical  ones.  Having 
left  the  bone,  they  terminate,  after  a  short  course,  in  the  common 
venous  system.  They  arise  exclusively  from  the  spongy  and  compact 
structure,  by  extremely  fine  arborescent  branches,  which,  uniting  suc- 
cessively, form  trunks  ;  these  trunks  penetrate  the  compact  tissue,  and 
escape  from  the  bone  by  orifices  which  are  uniformly  smaller  than  the 
bony  canals  of  which  they  are  the  terminations.  The  canals  are  formed 
of  compact  substance,  continued  from  the  external  surface  of  the  bone, 
and  are  lined  by  the  contained  veins.  They  are,  in  fact,  the  same 
with  the  Haversian  canals.  The  parietes  of  the  canals  are  penetrated 
by  smaller  veins  entering  into  the  larger.  M.  Dupuytren  is  of  opinion 
that  only  the  internal  membrane  of  the  venous  system  exists  in  this 
set  of  veins ;  that  it  adheres  closely  to  the  bone,  so  as  to  be  incapable 
of  exerting  any  action  upon  the  blood;' that  it  is  very  thin,  weak,  trans- 
parent, and  is  thrown  into  numerous  valves.  The  several  sets  of 
arteries  and  of  veins  respectively  anastomose  with  one  another. 

1  Would  not  this  furnish  a  hint  that  the  arteries   from  which  fat   proceeds  are  different 
from  other  arteries,  and  that  this  distinction  may  prevail  generally1? 

2  Propositions  sur  quelques  points  d'Anatomie,  Physiologie,  &c.,  Paris,  1803. 

3  Exposition  de  la  Structure  de  I'Encephale,  Paris,  1807. 


90  SKELETON. 

Lymphatic  vessels  are  generally  seen  only  on  the  surface  of  the 
bones.  Mr.  Cruikshank,  however,  on  one  occasion,  while  injecting  the 
intercostal  lymphatics,  passed  his  mercury  into  the  absorbents  of  a 
vertebra,  and  afterwards  saw  them  ramifying  through  its  substance  j1 
a  fact  which,  along  with  what  is  known  of  the  power  of  exfoliation  in 
bones,  proves  sufficiently  the  existence  of  such  vessels  in  them.  A  few 
other  anatomists,  as  Soemmering,  Breschet,  and  Bonamy,  lay  claim  to 
similar  observations.  The  testimony  of  the  former  may  be  considered 
as  going  far  to  confirm  the  fact,  as  he  has  all  along  been  admitted  as 
one  of  the  most  accurate  and  cautious  observers  of  modern  times.  The 
opinion  is,  however,  rejected  by  others  of  almost  equal  celebrity. 

Nerves  have  also  been  traced  into  the  bones,  accompanying  for  some 
distance  the  nutritious  arteries  on  the  medullary  membrane;  but  there 
is  no  proof  yet  of  nerves  being  distributed  to  the  osseous  substance 
itself*8 


CHAPTER  II. 

SECT.  I. — OF  THE  PERIOSTEUM. 

THE  membrane  which  surrounds  the  bones  externally  is  called  perios- 
teum (Periosteum  Externum),  and  is  extended  over  their  whole  surface, 
excepting  that  covered  by  the  articular  cartilages.  As  this  membrane 
approaches  the  extremities  of  the  bones,  it  is  blended  with  the  liga- 
ments uniting  them  to  each  other,  from  which  the  ancients  adopted 
the  opinion,  that  the  ligaments  and  periosteum  were  the  same.  Many 
fibres  pass  to  the  bone  from  the  periosteum,  by  which  it  is  caused  to 
adhere.  These  fibres  are  more  numerous  and  strong  at  the  extremities 
than  in  the  middle  of  the  cylindrical  bones  ;  also  upon  the  thick  bones, 
than  upon  the  flat  ones.  The  blood-vessels  of  the  bones  accompany 
these  fibres  and  contribute  to  the  adhesion.  The  periosteum  is  united 
to  the  muscles  and  to  the  parts  lying  upon  it,  by  cellular  substance. 

The  organization  of  the  periosteum  is  fibrous ;  the  fibres  pass  very 
much  in  the  same  direction  with  the  fibres  of  the  bones,  excepting  the 
flat  bones,  on  which  they  are  not  radiated.  These  fibres  have  different 
lengths ;  the  more  superficial  are  longer,  while  the  more  deeply  seated 
extend  but  a  small  distance.  Inflammation  develops  the  fibres  in  a 
striking  manner,  by  occasionally  making  the  membrane  as  thick  as  an 
aponeurotic  expansion. 

The  blood-vessels  of  the  periosteum  are  numerous,  and  can  be  easily 
injected.  They  come  from  the  contiguous  trunks,  and  ramify  minutely, 
into  a  vascular  net-work,  many  of  whose  branches  penetrate  into  the 
bone,  and  have  the  distribution  already  mentioned.  A  few  lymphatic 
vessels  have  been  observed  in  it.  Its  nerves  have  not  been  clearly  dis- 

1  Anatomy  of  Absorbing  Vessels,  p.  98,  London,  1790. 

2  Beclard,  Elemens  d'Anatomie  Generate,  Paris,  1823. 


THE  PERIOSTEUM. 


91 


The  External 
Periosteum  laid 
open  and  turned 
off  from  a  young 
humerus. 


covered,  though  the  sensation  of  extreme  pain,  when  vio- 
lence is  done  to  it  in  an  inflamed  state,  may  be  thought 
a  proof  of  their  existence.  In  health  its  sensations  are 
null,  or  extremely  obscure.1 

The  adhesion  of  the  periosteum  to  the  bones  varies  in 
the  several  periods  of  life.  In  infancy  it  may  be  sepa- 
rated from  them  with  great  facility ;  in  the  adult  it  ad- 
heres more  strongly  in  consequence  of  its  internal  face 
having  taken  on  a  secretion  of  bone,  by  which  it  is  blended 
intimately  with  the  bone  it  surrounds  ;  and  in  old  age  it 
is  still  more  adherent,  from  the  progress  of  its  ossification. 
It  is  thick  and  soft  in  the  infant,  and  becomes  thinner 
and  more  compact  as  life  advances. 

The  periosteum  receives  the  insertion  of  tendons,  of 
ligaments,  and  of  the  aponeuroses.  For  some  years  after 
birth,  owing  to  their  slight  attachment  to  the  bones,  all 
these  parts  may  be  torn  from  them,  with  but  compara- 
tively little  force.  Bichat,2  having  advocated  the  opinion 
that  the  internal  laminae  of  the  periosteum  became  ossi- 
fied in  the  adult,  considered  this  as  a  means  by  which  all 
the  afore-mentioned  insertions  into  it  were  identified  with 
the  bones,  and  thus  accounted  for  the  great  degree  of  tenacity  with 
which  they  adhere,  and  the  immense  force  they  are  capable  of  sustain- 
ing, without  being  detached  from  their  insertions.  In  this  tendency  to 
ossify,  the  periosteum  manifests  a  great  similitude  to  other  fibrous  mem- 
branes, as  the  dura  mater,  the  sclerotica,  and  the  tendons. 

The  real  state  of  the  case  is  that  the  periosteum  does  not  insinuate 
itself  as  a  distinct  layer  between  such  insertions  and  the  bone.  It 
ought  rather  to  be  said  that  the  fibrous  character  which  is  common 
to  the  periosteum,  the  animal  part  of  bone,  and  the  tendons,  liga- 
ments, and  aponeuroses,  is  so  uniform  that,  if  a  bone  with  these  others 
attached  is  softened  in  an  acid,  it  will  be  seen  that  there  are  no  strict 
limits  observed  between  them,  but  that  these  several  textures  run  into 
each  other,  and  have  their  filaments  so  continuous,  that  they  have  no 
lines  of  separation  whatever,  but  are  rather  identified  or  blended,  the 
one  with  the  other,  wherever  an  insertion  or  firm  attachment  is  in 
question. 

The  use  of  the  periosteum  is  to  conduct  the  blood-vessels  to  the 
bones ;  to  protect  the  latter  from  the  impression  of  the  muscles,  and 
other  organs,  which  come  in  contact  with  them ;  to  keep  the  ossifica- 
tion of  the  bones  within  its  proper  boundaries ;  to  give  shape  to  them ; 
and  to  secrete  bone  in  the  growing  state  or  in  fractures.  Finally, 
as  was  suggested  by  the  late  Dr.  Physick,  it  exerts  a  very  happy 
influence  in  turning  from  the  bones  suppurations  in  their  vicinity, 
which  would  otherwise  be  pernicious  to  them. 

1  Pnrkinje,  it  is  said,  has  found  a  copious  net-work  of  nervous  filaments  in  the  perios- 
teum. 

2  Anatomic  Generals. 


92  SKELETON. 


SECT.  II. — OF  THE  MEDULLA,  AND  ITS  MEMBRANE,  CALLED  THE  INTERNAL 
PERIOSTEUM,  OR  ENDOSTEUM. 

The  Marrow  (Medulla)  is  contained  in  a  very  fine  vascular  membrane 
{Periosteum  Internum),  lining  the  internal  cavities  of  the  bones,  ai\d, 
sending  into  their  compact  substance  very  delicate  filaments.  The 
existence  of  this  membrane  has  been  denied,  but  it  may  be  established 
by  sawing  a  bone  in  two,  and  approaching  the  cut  end  to  the  fire,  so  as 
to  melt  out  the  marrow;  also,  by  digesting  a  bone  for  some  days  in  hot 
spirits  of  turpentine,  or  by  immersing  it  in  an  acid,  in  which  cases  the 
membrane  becomes  crisp  and  distinct.  Its  delicacy  is  so  extreme  that 
it  can  only  be  compared  to  an  amorphous  film.  In  this  state  it  may  be 
traced,  lining  the  whole  cylindrical  cavity  of  the  long  bones,  and  ex- 
tending itself  to  their  extremities.  It  also  exists  in  the  diploic  or  cel- 
lular structure  of  all  the  other  bones;  but  it  is  scarcely  possible  to 
demonstrate  it  there  in  a  very  distinct  manner,  owing  to  its  extreme 
tenuity. 

The  medullary  membrane  is  composed  principally  of  the  minute  and 
numerous  blood-vessels  spent  upon  the  internal  surface  of  the  bones, 
aided  by  a  very  fine,  soft,  areolar  tissue,  merely  sufficient  in  quantity 
to  fill  up  the  meshes  between  the  frequent  anastomoses  of  the  vessels. 
From  the  latter  cause,  it  is  compared  to  the  pia  mater  and  to  the  omen- 
turn.  It  has  been  stated  that  its  blood  was  derived  from  the  nutritious 
artery,  which  communicates  freely  with  the  other  arteries  of  the  bones. 
This  membrane  is  so  arranged  as  to  form  along  the  course  of  the  blood- 
vessels small  vesicular  appendages  which  contain  the  marrow,  and  bear 
some  analogy  to  a  thick  bunch  of  grapes,  hanging  from  the  several 
pedicles  of  the  stem. 

Its  nerves  are  extremely  small;  they  enter  by  the  nutritious  foramen, 
and  have  been  particularly  observed  by  Wrisberg  and  Klint.1  They 
have  not,  as  said,  been  traced  ramifying  in  the  substance  of  the  bone, 
but  follow  for  some  distance  the  course  of  the  principal  arteries. 

With  the  exception  of  Mr.  Cruikshank's  solitary  injection  of  a  ver- 
tebra, and  the  few  anatomists  making  similar  declarations  alluded  to 
before,  p.  90,  no  lymphatics  have  been  observed  satisfactorily  on  this 
medullary  membrane ;  and  such  lymphatic  trunks  of  the  external  perios- 
teum as  are  supposed  to  arise  from  the  medullary  membrane  have  not 
been  traced  nearer  to  it  than  the  orifice  of  the  nutritious  canal. 

Marrow. — A  greasy  substance,  as  already  stated,  fills  the  cells  of  the 
bones;  it  does  not,  in  its  composition,  differ  from  common  fat;  its 
granules,  however,  seem  to  be  somewhat  finer.  From  its  resemblance 
in  position  to  the  pith  of  vegetables,  it  has  obtained  the  name  of  medulla, 
or  marrow. 

Some  differences  exist  in  the  nature  of  the  medullary  membrane  or  en- 
dosteum ;  for  example,  that  part  of  it  which  is  reflected  over  the  cells  in 
the  extremities  of  the  long  bones,  and  in  the  whole  interior  of  the  flat  and 
of  the  thick  ones,  contains  a  much  more  bloody  and  watery  marrow 
what  is  found  in  the  cylindrical  cavities  of  the  long  bones;  the 

i  Beclard,  loc.  cit. 


MEDULLA,  AND  ITS  MEMBRANE.  93 

latter,  indeed,  resembles  closely,  as  just  stated,  common  adeps,  present- 
ing no  essential  differences  from  it.  The  fat  in  the  humerus  of  the 
bullock  amounts  to  96  per  cent,  of  the  medulla,  and  in  very  corpulent 
human  subjects,  cannot  be  much  less;  it  deviates  much,  however,  from 
that  proportion,  according  to  the  general  state  of  health,  until  in  ex- 
tremely protracted  diseases  the  adipose  matter  disappears,  as  in  all 
other  parts  of  the  body.  On  the  contrary,  the  medulla  of  the  diploe, 
and  cellular  structure  of  all  bones,  makes  a  reddish,  gelatiniform  pulp, 
which,  according  to  the  analysis  of  Berzelius,1  has  scarcely  a  trace  of 
fat;  it  being  composed  of  water  75.5;  and  solid  matters  24.5,  identi- 
cal with  those  eliminated  from  meat  by  water,  as  albumen,  coloring 
matter,  extract  of  meat,  and  the  ordinary  saline  substances.  These 
circumstances  have  given  occasion  to  divide  the  medullary  membrane 
into  two  varieties. 

That  variety  contained  in  the  cellular  extremities  of  the  long  bones, 
and  in  the  spongy  bones  generally,  is  in  a  superior  degree  vascular. 
The  part  filling  the  meshes  of  its  vessels  is,  however,  so  imperfect,  that 
Bichat  declared  his  inability  to  find  it,  and  that  the  number  of  the  fine 
vessels  was  what  gave,  fallaciously,  the  appearance  of  a  membrane; 
while,  in  fact,  the  intervals  between  them  were  large,  to  allow  the  fat 
to  come  into  contact  with  the  naked  bone.  The  probability  of  this  de- 
ficiency is  confirmed  by  the  difficulty  of  finding  a  membrane  in  the 
microscopical  pores  of  the  compact  substance,  yet  the  existence  of  fat 
in  it  is  proved  by  its  becoming  greasy  when  insulated  and  exposed  to 
heat.  There  may  notwithstanding  be  extremely  attenuated  fat  vesicles 
here  as  elsewhere,  with  the  existence  of  adeps.  It  is  from  the  great 
abundance  of  blood  in  this  variety  of  the  medullary  tissue  that  the 
proportion  of  its  adeps  is  small. 

The  second  variety  of  medullary  membrane  is  displayed  in  the  cells 
and  in  the  cylindrical  cavity  of  the  diaphysis  or  body  of  the  long  bones. 
Its  membranous  cells  communicate  freely  with  one  another,  when  the 
membrane  is  entire;  but  according  to  the  observations  of  Bichat,  not 
with  such  as  are  in  the  epiphyses  of  the  bones,  and  the  line  of  demark- 
ation  is  abrupt  and  well  defined.  This  is  proved  by  attempts  to  inflate 
the  one  from  the  other;  the  air,  in  such  cases,  passes  with  great  diffi- 
culty. The  texture  of  this  medullary  membrane,  from  its  extreme  deli- 
cacy in  a  natural  state,  is  rather  obscure,  but  it  is  occasionally  well 
developed  in  disease.  Its  sensibility  has  not  been  very  apparent  in  such 
cases  of  amputation  as  I  have  seen,  though  it  is  said  by  some  to  be 
extremely  exquisite.  In  whatever  degree  the  sensibility  exists  in  dif- 
ferent subjects,  it  is  always  more  apparent  in  the  middle  than  near  the 
extremities  of  the  long  bones;  which  may  be  accounted  for  by  its  nerves 
constantly  entering  at  the  nutritious  foramen,  and  extending  from  thence 
towards  the  extremities. 

It  will  now  be  understood  that  a  very  strong  difference  exists  between 
the  external  and  the  internal  periosteum;  the  first  is  decidedly  of  the 
white  fibrous  tissue.  The  internal  is  a  very  delicate  areolar  tissue,  al- 
most amorphous  everywhere,  and  characterized  in  certain  bones,  espe- 
cially the  long,  by  the  presence  of  the  fat  vesicle,  which  secretes  the 

1  Traite  de  Ckimie,  t.  iii.  p.  486. 


94  SKELETON. 

marrow.     This  secretion,  however,  takes  place  only  very  obscurely  in 
the  flat,  the  thick,  and  the  articular  ends  of  the  long  bones. 

The  medullary  membrane,  besides  its  use  in  secreting  the  marrow,  is 
highly  serviceable  to  the  nutrition  of  the  bones,  as  proved  in  the  expe- 
riments of  Trojat,  who,  by  destroying  it,  produced  their  death,  and  an 
artificial  necrosis,  which  was  cured  in  the  usual  way  by  a  new  secretion 
of  bone  from  the  periosteum.  The  marrow  which  it  contains  in  the 
adult  is  not  perceptible  in  the  fcetus. 


CHAPTER  III. 

ON  OSTEOGENY. 

SECT.  I. — OF  THE  DEVELOPMENT  OF  BONES. 

AT  birth,  though  the  skeleton  is  sufficiently  solid  to  preserve  the 
shape  of  the  individual,  yet  it  is  very  imperfect  in  many  particulars, 
which  will  be  pointed  out  more  in  detail  hereafter.  At  present  it  may 
be  stated  that  the  ends  of  all  the  long  bones  are  mostly  cartilaginous ; 
the  carpus  and  tarsus  are  nearly  in  the  same  state;  the  vertebrae,  true 
and  false,  have  their  processes  very  imperfect,  and  consist,  each  in 
several  distinct  pieces,  united  by  the  remains  of  the  cartilaginous  state. 
Several  of  the  bones  of  the  head  are  in  the  latter  condition;  and  the 
sutures  are  so  imperfect  that  the  flat  bones  readily  ride  over  each  other 
from  the  thinness  of  their  edges,  and  also  have  the  angles  rounded, 
which  occasions  the  vacancies  called  fontanels. 

From  the  early  embryo  state  to  the  completion  of  the  skeleton,  three 
stages  are  observed  in  the  progress  of  ossification ;  the  first  is  mucous 
or  pulpy,  the  second  cartilaginous,  and  the  third  calcific  or  osseous. 

I.  The  Mucous  Stage.    It  is  seen  at  a  very  early  period  after  the  em- 
bryo has  been  received  into  the  womb,  and  presents  itself  under  two  modi- 
fications.    In  the  one,  from  the  general  softness  of  the  whole  structure 
of  the  embryo,  and  from  the  apparently  homogeneous  nature  of  its  con- 
stituents, the  mucous  rudiments  of  bone  do  not  distinguish  themselves 
from  the  other  parts.    This  condition,  however,  is  soon  changed  into  one, 
and  that  before  the  expiration  of  the  first  month  of  gestation,  in  which 
these  rudiments  assume  a  solidity  and  color  which  mark  them  off,  both 
to  the  eye  and  to  the  touch,  from  the  still  softer  parts  surrounding  them. 

II.  The  Cartilaginous  Stage.    About  the  expiration  of  the  first  month, 
the  mucous  stage  is  converted  into  the  cartilaginous,  and  its  substance 
is  cartilage  cells  imbedded  in  a  pellucid  matrix;  the  consistence  of  the 
bones  then  increases  continually  by  the  accumulation  of  these  consti- 
tuents.    Bichat  makes  a  remark  on  this  subject  which  has  been  confirmed 
by  the  experiments  of  Scarpa,  though  erroneous  deductions  have  been 


DEVELOPMENT  OF  BONES.  95 

made  by  the  latter:  that  we  do  not  see,  during  the  formation  of  the  car- 
tilages, those  longitudinal  striae  in  the  long  hones,  radiated  in  the  flat, 
and  mixed  in  the  thick  hones,  which  distinguish  the  osseous  state.  The 
cartilaginous  state  presents  another  peculiarity  worthy  of  observation : 
all  the  bones  which  in  a  more  advanced  stage  are  to  be  united  by  carti- 
lage, as  the  vertebrae,  those  of  the  pelvis,  and  of  the  head,  make,  in 
their  groups,  respectively,  but  one  piece;  while  those  which  are  to  be 
united  by  ligament,  and  consequently  to  be  movable,  as  the  femur,  the 
tibia,  the  clavicle,  and  so  on,  are  respectively  insulated.  In  the  pure 
cartilaginous  state  the  bones  have  neither  an  areolar  structure  nor  me- 
dullary cavities,  and  consist  in  a  solid  mass;  the  form  of  which  is  suffi- 
ciently definite,  and  has  its  surface  covered  by  periosteum. 

The  flat  bones  of  the  cranium  seem  to  be  an  exception  to  the  general 
rule  of  a  preliminary  cartilaginous  state,  and  are  commonly  thought  to 
be  such.  Bichat  says  that  the  appearance  is  delusive,  from  the  cartilage 
being  extremely  soft  and  thin,  and  concealed  by  the  pericranium  on 
the  one  side,  and  the  dura  mater  on  the  other ;  but  that  a  careful  dis- 
section enables  one  to  distinguish  it  from  this  double  envelop.1 

The  idea  of  a  membranous  or  rather  intra-membranous  ossification 
simply,  has  been  further  corroborated  by  Professor  Sharpey,  in  the 
case  of  the  tabular  bones  or  flat  ones  of  the  cranium.  In  them  it  is 
ascertained  that  an  intermediate  membranous  layer  is  between  the 
dura  mater  and  the  pericranium.  This  layer  is  made  up  seemingly 
of  filaments  of  cellular  and  of  fibrous  tissue  blended  with  granular  cor- 
puscles, and  united  by  a  soft  amorphous  or  a  faintly  granular  tissue. 
The  corpuscles  are  true  cells,  having  an  envelop  and  granular  con- 
tents; they  are  the  size  of  blood  corpuscles,  but  some  of  them  two  or 
three  times  larger.  The  filaments  of  the  intermediate  membranous 
layer  are  in  insulated  bundles  and  also  form  a  reticulated  connection 
with  one  another.  They  receive  the  ossific  deposit,  which  is  conse- 
quently in  its  early  stages  evidently  reticular,  and  only  becomes  com- 
pletely laminar  by  the  finish  of  the  bone  itself.  It  is  certainly  not 
repugnant  to  common  observation  that  parts  of  the  skeleton  may  have 
a  simply  membranous  matrix,  as  instances  are  so  numerous  of  bone 
being  formed  in  membranes  elsewhere.2 

III.  The  Calcific  Stage. — The  calcareous  matter  begins  to  be  depo- 
sited when  the  rudiments  of  the  bone  have  become  decidedly  cartilagi- 
nous, with  the  exception  of  a  few  mucous  points.  In  certain  bones 
this  change  is  observable  about  the  commencement  of  the  second  month3 
after  conception  :  J.  F.  Meckel  has  placed  it  about  the  eighth  week. 
The  color  of  the  cartilage  first  becomes  deeper,  and,  in  the  region 
where  ossification  is  to  commence,  is  of  a  well-marked  yellow.  The 
blood-vessels,  which  before  this  carried  only  the  transparent  part  of 
the  blood,  now  dilate,  so  as  to  admit  the  red  particles,  and  a  red  point 
is  perceived,  called  the  Punctum  ossificationis,  from  its  receiving  the 
first  calcareous  deposit.  This  deposit  is  always  near  the  very  centre 

1  Loc.  cit. 

2  For  further  discussion  on   the  formation  of  bone,  see  Human   Anatomy  by  Professors 
Quain  &  Sharpey,  edited  by  Joseph  Leidy,  M.  D.,  pp.  83  to  94,  vol.  1st,  Phila.  Ib49. 

3  Beclard,  loc.  cit.     Bichat,  loc.  cit. 


86  SKELETON. 

of  the  cartilaginous  rudiment,  and  not  at  its  surface ;  the  portion  of 
cartilage  nearest  to  it  is  of  a  red  color  ;  but,  a  little  farther  off,  opaque 
and  hollowed  into  canals.  The  ossification  increases  on  the  surface  of 
the  cartilage,  and  in  its  interstices,  by  continual  deposits,  which  are 
always  preceded  by  that  condition  just  mentioned.  The  canals  of  the 
cartilage  transmit  the  blood-vessels,  and  are  large  at  the  beginning  of 
ossification  ;  but,  as  the  process  advances  and  is  completed,  they  dimin- 
ish gradually,  and  finally  disappear. 

The  cartilage  of  ossification,  like  the  permanent  cartilages,  as  the 
costal,  the  laryngeal;  and  some  others,  is  composed  of  a  semi-trans- 
parent and  somewhat  fibrous  or  filamentous  material.  Immersed  in 
this  are  numerous  microscopic  corpuscles  or  cartilage  cells,  flattened 
slightly  and  containing  a  nucleus  or  several  granules. 

The  definite  process  of  ossification  begins  by  the  deposition  of  cal- 
careous matter  in  a  reticulated  manner  in  the  spaces  of  the  semi-trans- 
parent matter  between  these  corpuscles.  According  to  Dr.  Sharpey,1 
these  corpuscles  had  no  definite  linear  arrangement  previously;  but  upon 
the  approach  of  the  bony  deposit  they  assume  one,  with  their  long 
diameter  transverse,  and  collect  into  longitudinal  rows  or  oblong 
groups,  the  intervals  of  which  are  filled  by  the  transparent  matrix : 
and  the  ends  look  towards  the  ossifying  surface.  The  bony  deposit 
finally  surrounds  completely  the  cartilaginous  corpuscles  individually, 
and  the  latter  themselves  are  transformed  into  bone,2  as  proved  by 
muriatic  acid,  which  removing  the  bone  restores  the  appearance  of  the 
original  cartilaginous  corpuscles. 

It  is  asserted3  that,  after  the  ossification  of  the  spaces  between  the 
corpuscles  or  cartilage  cells,  the  latter  attach  themselves  to  the  ossi- 
fication or  cancellated  structure  as  it  exists,  and  in  being  ossified  them- 
selves their  nuclei  escape  the  process,  and  finally  become  the  lacunae  or 
corpuscles  of  Purkinje,  and  that  a  new  substance  or  blastema  is  formed 
in  the  cancelli,  from  which  probably  the  vessels  of  the  bone  are  deve- 
loped for  its  future  growth.  The  Purkinjean  corpuscle  is  considered 
by  Schwann,  Hassell,  and  Leidy  to  be  derived  from  the  pre-existing  car- 
tilage cell,  and  its  radiating  canaliculi  to  be  elongations  of  the  wall  of 
the  cell.  In  the  progress  of  ossification,  as  an  ossific  net-work  is  formed 
by  the  deposit  of  the  osseous  salts  around  the  cartilage  cells,  Dr. 
Leidy4  considers  these  elongations  to  be  made  at  the  same  period  with  the 
ossific  deposits  and  not  before,  and  that  the  nucleus  of  the  Purkinjean 
corpuscle  disappears  a  short  time  after  the  completion  of  the  corpuscle. 
The  cancelli  when  first  formed  are  closed  cavities,  but  by  farther  develop- 
ment become  Haversian  canals  and  what  they  are  in  the  perfect  state.5 

An  extension  of  the  preceding  processes,  with  a  corresponding  deve- 
lopment or  generation  of  new  cartilaginous  corpuscles,  finishes  finally 
the  complete  fabric  of  the  skeleton. 

The  progress  of  calcification  is  somewhat  modified  in  the  three  clashes 
of  bones. 

1   Loc.  cit.  p.  87.          2  Miescher  de  Infl.  Oss.  1836.  3  Todd  and  Bowman,  p.  120. 

4  Proceedings  of  Acad.  Nat.  Sc.  Philad.  for  Dec.  1848,  p.  117. 

5  This  process  has  been  explained  by  Mr.  Tomes,  see  Todd  and  Bowman,  ut  supra;  and 
also  by  Quain  and  Sharpey,  Human  Anat.  p.  b9,  Phila.  edit. 


DEVELOPMENT  OF  BONES.  97 

In  the  Long  bones  a  small  ring  is  observed  to  form  early,  near  their 
centre,  and  to  be  perforated  on  one  side  by  the  nutritious  artery.  This 
ring  has  its  parietes  thin,  but  broad,  and  its  cavity  is  the  beginning  of 
the  medullary  canal.  It  is  made  of  very  delicate  fibres  which  advance 
towards  the  extremities  of  the  bone,1  and  at  the  same  time  increase  in 
thickness  ;  so  that  at  birth,  the  body  or  diaphysis  is  generally  finished. 
Commonly,  at  a  period  subsequent  to  birth,  but  differing  in  the  several 
bones,  their  cartilaginous  epiphyses  also  begin  to  ossify,  by  the  deve- 
lopment in  their  centre  of  points  of  ossification  which  present  the  phe- 
nomena already  mentioned.  The  cartilaginous  state  of  the  epiphysis 
gradually  disappears  by  retiring  from  the  articular  end  of  the  bone 
towards  its  diaphysis  ;  and,  just  before  its  complete  removal,  it  appears 
as  a  thin  lamina,  gluing  the  end  or  epiphysis  of  the  bone  to  its  body. 
Several  of  the  apophyses  of  the  long  bones  are  also  formed  from  dis- 
tinct points  of  ossification. 

The  calcification  or  ossification  of  the  Flat  or  Broad  bones  begins  by 
one  or  more  points,  according  to  the  bone  being  of  a  simple  shape  as 
the  parietal ;  of  a  double  shape  or  symmetrical,  as  the  frontal,  where 
there  are  two  points  of  ossification  ;  or  of  a  compound  shape,  as  the 
occipital  and  temporal,  where  there  are  several  points.  The  com- 
mencement of  ossification  in  them  is  also  manifested  by  the  appearance 
of  a  red  vascular  spot  in  the  cartilaginous  or  membranous  rudiment,  in 
which  the  osseous  matter  is  deposited,  and  from  which  it  progresses  in 
radiated  lines.  The  periphery  of  this  circle  of  rays  presents  intervals 
between  the  fibres,  giving  it  the  appearance  of  the  teeth  of  a  fine  comb  : 

Fig.  17. 


A  view  of  the  Punctum  Ossificationis  in  the  frontal  bone  of  a  Foetus— the  radiating  lines  from 
the  central  point  are  also  shown. 

these  intervals  are  subsequently  filled  up  by  the  sections  of  radii  start- 
ing from  them,  and  so  on  successively  till  the  bone  is  finished.  In  the 
infantile  head,  the  several  radii  grow  at  a  rate  nearly  equal ;  so  that 
where  the  bones  are  angular,  the  angles  being  most  distant  from  the 
centre  of  ossification  are  finished  last  of  all,  from  which  result  the  fon- 
tanels.  Where  the  bones  are  intended  to  be  kept  distinct  from  each 

1  Bichat,  loc.  cit. 
VOL.  I. — 7 


98 


SKELETON. 


other,  their  fusion  is  prevented  by  a  membranous  partition  ;  but  when 
they  are  to  coalesce  into  one  piece,  only  cartilage  is  found  between 
their  edges,  and  this  is  subsequently  ossified. 

In  some  of  the  flat  bones,  as  the  sternum  and  the  sacrum,  there  are, 
first  of  all,  many  distinct  points  of  ossification,  which  quickly  unite 
into  a  smaller  number  ;  they  then  remain  stationary  for  a  number  of 
years,  but  finally  all  unite  into  one  piece. 


Fig.  18. 


The  calcification  or  ossification  of  the  thick  bones  begins  by  one  or 
more  points,  according  to  the  simplicity  or  com- 
plexity of  their  figures.  The  bones  of  the  tarsus 
and  of  the  carpus  have  each  but  one  point,  while 
those  of  the  spine  have  several.  The  former  two, 
as  stated,  are  almost  entirely  cartilaginous  at  birth. 
The  remaining  phenomena  of  ossification  in  these 
several  bones  are  the  same  as  has  been  mentioned. 
The  centres  of  calcification  show  themselves  at 
different  times  in  the  different  bones.  Gerber1 
considers  the  process  to  occur  first  about  the  sixth 
week  in  our  larger  domestic  animals.  The  order 
he  lays  down  is  first  the  vertebrae  ;  then  the  lower 
jaw  ;  next  the  os  frontis  ;  next  the  bones  of  the 
face.  The  middle  portions  of  the  ribs  are  ossified 
at  an  early  date,  and  almost  cotemporaneously 
the  larger  bones  of  the  extremities  ;  the  thoracic 
anticipating  the  abdominal.  We  next  have  the 
cylindrical  bones  of  the  hands  and  feet,  and  finally 
the  carpus,  the  tarsus,  and  the  patella,  whose  ossi- 
fication begins  somewhat  before  birth  or  shortly 
after.  Messrs.  Todd  and  Bowman2  assert  (mean- 
^g,  as  I  understand,  the  human  subject),  that  the 
°ssificati°n  °f  the  clavicle  is  the  first,  it  commencing 
during  the  fourth  week  ;  the  vertebrae  and  pelvic 
bones  they  set  down  as  later. 


°fThefuppeS; 

naif  is  dividcartnagietud6" 
Bone,'  whichartermnateB 


SECT.  II. — ON  THE  MANNER  IN  WHICH  BONES  GROW. 

After  the  cartilaginous  condition  of  the  bones  has  been  supplied  by 
the  deposit  of  osseous  matter,  and  they  are  finished,  with  the  excep- 
tion of  the  epiphyses  being  fused  into  their  respective  bodies,  the  bones 
still  continue  to  grow  till  the  individual  has  reached  a  full  stature. 
This  is  effected  by  the  successive  addition  of  new  matter  to  the  old. 
The  long  bones  lengthen  at  their  extremities  ;  this  is  proved  by  the  fol- 
lowing experiment  of  Mr.  John  Hunter  :3  Having  exposed  the  tibia  of 
a  pig,  he  bored  a  hole  and  inserted  a  shot  into  each  extremity  of  the 
•liaphysis ;  the  distance  between  the  two  shots  was  then  accurately 
taken.  Some  months  afterwards,  when  the  animal  had  increased  con- 


1  Gen.  Anat.  p.  187. 

3  Experiments  and  Observations  on  the  Growth  of  Bones. 
Improvement,  vol.  ii.     London,  1800. 


2  Loc.  cit.  p.  116. 
Transactions  of  a  Society  for 


GROWTH  OF  BONES.  99 

siderably  in  size,  the  same  bone  was  examined,  and  the  shots  were 
found  precisely  at  their  original  distance  from  each  other,  but  the  ex- 
tremities of  the  bone  had  extended  themselves  much  beyond  their  first 
distance  from  the  shot.  The  flat  bones  increase  in  diameter  by  a 
deposit  at  their  margins,  a  circumstance  which  had  been  known  a  long 
time,  but  it  required  the  ingenuity  of  Mr.  Hunter  to  prove  conclusively 
that  the  long  bones  increase  in  length  by  a  similar  process,  and  not 
by  interstitial  deposit,  as  Duhamel  thought.  This  observation  explains 
most  satisfactorily  the  use  of  the  cartilage  between  the  diaphysis  and 
the  epiphysis  in  all  bones,  viz.,  that  it  is  preserved  for  forming  new  carti- 
lage corpuscles  and  for  the  purpose  of  offering  the  least  possible  resist- 
ance to  the  new  osseous  fibres,  which  grow  from  the  epiphyses  and 
from  the  diaphyses :  that  it  is  kept  for  this  end,  from  foetal  life  and 
without  any  material  change  in  thickness,  from  the  fourth  or  fifth  year 
to  the  sixteenth  or  eighteenth,  and  even  later,  when  it  disappears, 
because  there  is  no  longer  any  use  for  it,  in  consequence  of  the  bones 
having  attained  their  full  length. 

The  epiphyses  are  then  manifestly  intended  to  favor  the  elongation 
of  the  bodies  and  the  development  of  the  extremities  of  the  long  bones ; 
to  effect  the  same  purposes  in  some  of  the  flat  bones,  as  those  of  the 
pelvis,  and  to  permit  the  general  development  of  the  bodies  of  the 
vertebras.  The  calcification  of  the  epiphyses  commences  in  some 
bones  about  fifteen  days  before  birth,  as  in  the  inferior  extremity  of 
the  thigh  bone ;  and  in  others,  as  the  ossa  innominata,  not  till  the  fif- 
teenth year  or  thereabouts.  Many  of  the  processes  from  the  bones 
are  also  epiphyses,  as  the  trochanters  of  the  os  femoris,  the  tuber  of 
the  ischium,  the  acromion  scapulae,  the  seven  processes  of  a  vertebra, 
&c.,  and  are  developed  in  the  same  way.  The  time  at  which  they 
all  are  thoroughly  fused  into  the  bones  to  which  they  belong  ex- 
tends from  the  fifteenth  to  the  twenty-fifth  year ;  depending  upon 
the  individual  bone,  and  upon  varieties  of  constitution  in  different 
persons :  though  this  process  may  be  considered  as  completed,  gene- 
rally, in  the  female  at  the  age  of  eighteen,  and  in  the  male  at  twenty- 
one. 

The  increase  in  thickness  of  every  bone  depends  upon  a  continued 
secretion  from  the  internal  surface  of  the  periosteum,  at  first  soft  and 
mucous,  then  osseous :  when  this  secretion  is  arrested,  the  bones  cease 
to  grow  in  thickness,  which  commonly  occurs  some  time  after  they 
have  attained  their  full  length.  The  changes  which  subsequently  take 
place  in  them  are  those  of  interstitial  deposit  and  absorption  ;  the 
deposit  is  well  exemplified  in  inflammation  of  the  bones,  and  in  spina 
ventosa ;  the  absorption  in  the  diminution  of  the  bones  in  extreme  old 
age,  and  in  the  loss  of  the  alveolar  processes.  A  species  of  interstitial 
growth  is  also  admitted  to  occur  by  the  dilatation  of  the  primary  can- 
celli  and  of  the  Haversian  canals.  By  the  observation  of  Mr.  Tomes 
each  of  the  latter  is  found,  in  the  experiments  with  madder,  to  have  its 
walls  deeply  tinged  with  this  substance.1 

There  is  great  diversity  of  opinion  in  regard  to  the  secretion  of  bone 
from  the  periosteum,  in  the  growing  stage.  Mr.  Muller  is  so  decided 

1  Phys.  Anat.,  by  Todd  and  Bowman,  p.  123,  an.  1843. 


100  SKELETON. 

on  this  subject,  that  he  says,1  the  idea  that  bones  are  formed  by  the 
periosteum  appears  to  him  a  barbarism  unworthy  of  the  present  state 
of  physiology.  This  he  grounds  upon  the  principle,  that  one  organ 
in  a  part  cannot  be  the  nutrient  organ  of  another ;  therefore,  the  os- 
seous substance  being  organized  must  exclusively  assimilate  to  itself 
organized  matter.  This  opinion,  however  decided,  is  strongly  opposed 
by  preparations  in  the  Museum  of  St.  Bartholomew's  Hospital;  where 
in  cases  of  necrosis,  the  shaft  of  the  bone  having  died,  there  were 
plates  of  osseous  substance  on  the  inner  surface  of  the  periosteum. 
In  experiments  also  by  Mr.  Stanley,  a  portion  of  the  length  of  the 
bone  being  removed,  the  periosteum  being  left,  the  bone  was  repro- 
duced ;  but  this  latter  failed  in  a  case  where  the  periosteum  was  re- 
moved along  with  the  portion  of  bone.  Mr.  Syme  also  obtained  a 
secretion  of  bone  from  the  under  surface  of  the  periosteum,  where  the 
latter  had  been  kept  raised  and  separated  from  the  bone,  by  the  intro- 
duction of  a  thin  plate  of  metal.2  Also  in  an  ossification  (osteopliyte) 
appended  to  the  internal  face  of  the  dura  mater,  at  the  base  of  the  falx 
cerebri,  and  belonging  to  the  collection  of  the  University  of  Pennsyl- 
vania, the  production  was  found  by  Dr.  Leidy,  under  the  inspection  of 
the  microscope,  to  have  the  corpuscles  of  Purkinje  and  other  characters 
of  true  bone. 

The  following  figure,  drawn  from  it  by  Dr.  Leidy,  is  a  true  exhibit 
of  its  structure. 

Fig.  19. 


a.  Haversian  ossicles,    b.  Haversian  canals,    c.  Corpuscles  of  Purki  ije. 

Professor  Sharpey's  observations  go  to  confirm  absolutely  this  fact, 
for  he  declares  that  the  exterior  layers  of  bone  are  not  formed  in  a 
cartilaginous  matrix,  but  in  the  substance  of  a  membrane,  consisting 
of  fibres  and  of  granular  cells,  and  exactly  resembling  that  in  which 
the  flat  bones  of  the  cranium  are  developed.  This  membrane,  accord- 
ing to  him,  is  the  inner  layer  of  the  periosteum,  which  undergoes 
progressive  calcification  on  the  side  in  contact  with  the  bone,  while  it 
is  reproduced  on  the  outer  side. 

The  anatomists  of  Vienna  have  also  ascertained  that  in  the  preg- 
nant female,  a  thin  plate  of  bone  is  deposited  upon  the  internal  and  the 
external  face  of  the  bones  of  the  cranium  and  face,  which  in  some 
cases  that  I  saw  there,  was  so  free  from  the  bone,  that,  it  could  scarcely 
have  any  other  origin  than  the  periosteum. 

1  Physiol.  p.  408.  2  Muller,  ut  supra,  p.  471,  note  by  Dr.  Baly. 


GROWTH  OP  BONES.  101 

There  is  no  period  of  life  in  which  the  interstitial  absorption  and 
deposit  is  not  continually  occurring,  but  it  is  much  more  rapid  in 
young  and  growing  animals  than  in  the  adult  and  old.  The  experi- 
ments of  Mr.  Hunter  and  of  Duhamel  show  that,  when  a  growing 
animal  is  fed  upon  madder  (rubia  tinctorum),  the  bones  are  quickly 
colored  by  its  being  eliminated  from  the  blood,  owing  to  the  affinity 
with  phosphate  of  lime  ;  when  the  madder  is  withheld,  the  bones 
again  become  white ;  and  that  the  first  appearance  of  the  restoration 
of  the  latter  is  manifested  by  a  white  lamina  being  deposited  on  their 
surface.  Successive  layers  of  red  and  white  bone  may  be  thus  formed. 
The  madder,  under  such  circumstances,  is  a  long  time  in  getting  out 
of  the  bones.  I  fed  a  young  pig  for  one  month  on  it,  mixed  with  other 
food.  At  the  expiration  of  the  succeeding  five  months,  the  animal, 
having  grown  very  considerably,  was  killed.  The  interior  laminae  of 
all  the  bones  continued  to  be  deeply  tinged,  while  their  surface  from 
the  deposit  of  new  bone  had  become  white.  From  this  it  would  appear 
that  deposit  is  a  very  permanent  condition  in  bones  ;  it,  of  course, 
must  prevail  much  over  absorption,  else  their  growth  would  be  arrested. 

This  effect  of  madder,  first  observed  by  Belchier,  and  the  result  of 
the  affinity  between  madder  and  phosphate  of  lime,  may  be  proved  as 
follows,  out  of  the  body.  No  change  occurs  when  an  infusion  of  madder 
is  added  to  a  solution  of  muriate  of  lime ;  but,  if  a  solution  of  phosphate 
of  soda  be  added,  a  decomposition  occurs  in  the  two  salts,  and  muriate 
of  soda  and  phosphate  of  lime  are  then  formed.  The  madder  is  im- 
mediately attached  to  the  phosphate  of  lime,  and  the  latter,  being 
insoluble,  falls  at  once  down  as  a  crimson  lake-colored  precipitate. 
The  coloring  matter  of  the  madder,  when  it  is  used  as  food,  being 
introduced  into  the  circulation,  its  union  is  thus  established  with  phos- 
phate of  lime,  and  especially  with  that  which  is  on  the  eve  of  being 
deposited  in  our  tissues. 

In  very  young  animals,  according  to  Mr.  Tomes,1  one  day  is  suffi- 
cient to  tinge  the  entire  skeleton,  and  in  that  case,  the  Haversian 
canals  are  each  seen  to  be  the  centre  of  a  beautiful  crimson  ring.  In 
old  animals  the  process  is  much  slower,  owing  to  the  points  of  bone 
being  further  removed  from  the  blood-vessels,  and  therefore  reached 
more  slowly  through  the  process  of  imbibition,  which,  to  some  extent, 
must  always  take  place  in  tissues  not  wholly  vascular. 

At  the  same  time  that  the  periphery  of  each  bone  is  increasing  in 
its  dimensions,  the  medullary  canal  is  also  augmenting ;  this  arises  from 
an  absorption  going  on  internally,  while  the  deposit  is  making  exter- 
nally. Duhamel2  proved  this  by  a  curious  experiment.  He  surrounded 
a  cylindrical  bone  of  a  young  animal  with  a  metallic  ring ;  on  killing 
the  animal  some  time  afterwards,  he  found  the  ring  covered  externally 
by  a  secretion  of  bone,3  owing  to  the  growth  of  the  latter,  and  the 
medullary  canal  as  large  as  the  ring  itself.  Notwithstanding  the 
obvious  conclusion  from  this  experiment,  he  made  the  mistake  of  sup- 

1  Todd  and  Bowman,  p.  123. 

2  Mem.  de  1'Acad.  Roy.  des  Sciences,  an.  1739-41-43-40. 

3  If  a  string  be  tied  around  a  growing  tree,  the  same  thing  takes  place,  and  it  is   finally 
shut  up  in  the  ligneous  part. 


102  'SKELETON. 

posing  that  the  bone  had  enlarged  by  expansion,  and  not  by  a  deposit 
externally,  with  an  absorption  internally. 

As  the  individual  advances  in  life,  the  cylindrical  canal,  in  the  centre 
of  the  long  bones,  continues  to  enlarge  in  size  by  the  internal  absorp- 
tion, probably  by  means  of  the  internal  periosteum,  so  that  the  parietes 
of  the  bones,  which  in  early  life  were  much  thicker  than  the  canal,  and 
in  the  adult  are  also  of  considerable  thickness,  become  exceedingly 
thin  in  old  age,  resembling  thereby  a  stalk  of  Indian  corn  with  the 
pith  scooped  out.1  The  cells  of  the  cellular  structure  in  the  several 
bones  also  enlarge,  whereby  the  whole  weight  of  the  bones  is  much 
decreased  in  the  very  aged.  In  the  parietes  of  the  cranium,  in  extreme 
old  age,  there  is  rather  a  tendency  to  the  absorption  of  the  diploe,  and 
the  approximation  of  their  tables. 

The  bones,  also,  become  more  brittle  in  old  age,  in  consequence  of 
the  increase  of  calcareous,  with  a  diminution  of  gelatinous  matter.  The 
reverse  being  the  case  in  infancy,  they  are  more  flexible  than  in  the 
adult,  and  can  even  bear  to  be  twisted  or  bent  without  breaking.3 


SECT.  III.  —  ON  THE  FORMATION  OF  CALLUS. 

As*this  is  a  consequence  of  bones  being  fractured,  and  a  mode  that 
nature  takes  to  repair  the  accident,  there  is  some  resemblance  between 
it  and  the  primitive  formation  of  bone.  Owing  to  the  rupture  of  the 
blood-vessels  of  the  bone,  of  those  of  the  periosteum,  and  of  the  medul- 
lary membrane,  and  frequently  of  the  vessels  of  contiguous  parts,  the 
first  effect  of  the  accident  is  an  effusion  of  blood  into  the  cavity  of  the 
fracture.  The  several  contiguous  soft  parts  then  swell,  become  hard- 
ened and  inflamed,  and,  in  the  mean  time,  an  absorption  of  the  blood 
is  proceeding  ;  while  an  effusion  of  fibrin  or  coagulating  lymph  from 
the  ruptured  vessels  occurs  in  the  cavity  of  the  fracture.  This  is  in 
fact  a  nucleated  blastema.  A  ring,  the  thickest  part  of  which  is  pre- 
cisely over  the  seat  of  the  fracture,  is  formed  by  the  lacerated  parts 

1  There   are  several  examples  of  this  in  the  Wistar  Museum.      More  rarely  the  re- 
verse takes  place,  and  the  cavity  is  filled  up;  of  this  there  are  also  specimens.     We   have 
also  an  interesting  specimen  of  mollities  ossium,  or  an  absorption  spontaneously  of  the  cal- 
careous matter,  in  a  married  lady,  aged  43,  the  mother  of  five  children,  in  whom  the  thigh-bone 
was  broken,  without  known  violence,  in  two  places,  as  she  lay  carefully  in  bed.      All  the 
other  bones  of  her  skeleton  were  in  the  same  state  of  softening,  and  could  be  easily  cut  with 
a  knife.     The  case  has  been  detailed  by  the  physician  who  attended  her,  Dr.  J.  W.  Tenney. 
See  Am.  Journ.  Med.  Sciences,  1840. 

2  The  reported  instances  are  now  numerous,  where,  from    a  defective   organization  of 
bone,  fracture  was  produced  from  very  trivial  causes;   and  this  state  is  not  confined  to  any 
particular  age,  for  it  extends  from  infancy  to  advanced  life.     I  have  attended  a  fractured  os 
femoris  in  a  child  of  two  years,  from  a  stumble  in  walking  across  a  carpeted  floor.     In  ano- 
ther child  the  os  femoris  was  broken,  so  far  as  could  be  learned,  by  the  nurse  stooping  to 
reach  something  from  the  floor;  the  same  child  had  both  clavicles  broken,  without  any  one 
knowing  when  or  where;  the  left  side  was  flattened  from  the  fracture,  probably  a  partial 
one,  of  several   ribs,  equally  inexplicably.     In  a  third   child  the  tibia  was  broken  from  a 
trifling  fall  on  the  floor,  and  the  clavicle  from  striking  the  shoulder  moderately  against  the 
rounded  back  of  a  chair. 

In  these  several  instances  the  fragility  may  arise  either  from  the  abnormal  relation  of  the 
constituents  of  the  bone  to  each  other;  by  a  deficiency  of  animal  matter,  which  dimin- 
ishes the  tenacity  of  the  bone  ;  or  from  attenuation,  merely,  of  the  bone,  leaving  its  parietes 
too  thin  for  ordinary  accidents. 


FORMATION  OF  CALLUS.  103 

ossifying:  there  is  also  formed  in  the  interior  of  the  bone,  as  first  desig- 
nated by  Dupuytren,  a  sort  of  osseous  pin.  Till  this  moment  the  bone 
itself  remains  unchanged,  with  the  exception  of  a  coating  of  the  lymph 
on  its  broken  faces;  but  now  its  extremities  begin  to  coalesce  or  fuse 
themselves  into  each  other  by  a  fine  granular  osseous  deposit  in  the 
blastema,  it  being  the  permanent  callus;  the  superfluous  bony  matter  or 
provisional  callus  (the  ring  and  the  pin),  being  no  longer  necessary,  is 
absorbed,  and  the  cavity  of  the  bone  with  the  membranes  of  the  latter 
is  re-established.  In  this  case  it  will  be  seen  that  the  deposit  of  coagu- 
lating lymph  in  the  cavity  of  the  fracture  corresponds  with  the  mu- 
cous rudiments  of  the  foetal  bone,  and  that  the  remaining  phenomena 
of  ossification  are  the  same.  A  provisional  callus  in  the  human  subject 
is  thought  by  Mr.  Paget  to  be  very  rare.1 

Some  physiologists  have  attempted  to  give  to  the  periosteum  the  ex- 
clusive credit  of  the  formation  of  callus  :  the  view  is  erroneous,  because 
experiments  show  that,  even  where  the  periosteum  is  stripped  designedly 
from  the  fractured  ends  of  bones,  they,  nevertheless,  unite,  and  the 
periosteum  is  restored  when  the  callus  is  formed.  The  probability  then 
is  that  all  the  blood-vessels  (from  whatever  source  they  come)  which 
penetrate  the  organized  coagulating  lymph  secreted  between  the  frac- 
tured extremities,  convey  and  deposit  calcareous  matter. 

The  celebrated  Bichat  and  some  others  were  of  opinion  that,  in  every 
case  of  fracture  where  the  ends  of  the  bones  are  *not  kept  in  contact, 
granulations  spring  up  from  the  ruptured  surfaces  of  the  bone,  and  of 
its  membranes ;  that  these  granulations  first  receive  into  their  inter- 
stices a  soft  gelatinous  deposit,  then  a  cartilaginous  one,  and,  finally,  a 
calcareous  one,  by  which  the  bone  is  united.  This  process,  however,  is 
much  more  common  in  compound  fractures  which  suppurate,  and  may 
be  considered  rare  in  simple  ones.2 

When  the  calcareous  matter  begins  to  take  place  in  a  forming  callus, 
if  the  part  be  much  moved,  the  process  is  arrested,  the  blood-vessels  no 
longer  deposit  even  if  they  carry  calcareous  materials,  and  an  artificial 
joint  is  formed.  The  proper  period  of  restoration  being  once  passed, 
the  vessels  sink  into  an  inactive  state  from  which  they  have  little  or  no 
disposition  to  rouse  themselves.  Under  these  circumstances,  the  late 
Dr.  Physick  proposed,  many  years  ago,  the  introduction  of  a  seton 
through  the  cavity  of  the  fracture,  and  the  retaining  of  it  there  for  a 
long  time,  for  the  purpose  of  stimulating  the  vessels.  The  plan  has 
now  been  repeatedly  tried,  with  success,  upon  the  cylindrical  bones, 
and,  in  one  instance,  upon  the  lower  jaw.3 

Callus  is  formed  much  more  speedily  in  young  persons  than  in 
jld;  occasionally,  however,  we  meet  with  instances  in  which  the  rapidity 
of  its  deposit  in  the  latter  is  remarkable.  I,  for  example,  treated,  in 
1826,  a  female  of  ninety,  for  a  simple  fracture  of  the  os  humeri,  which 
was  cured  at  the  end  of  five  weeks. 

1  Carpenter's  Physiol.  Par.  206. 

a  For  a  good  account  of  the  reproduction  of  bone,  see  Mailer's  Physiology  by  Baly,  p.  455, 
&c.,  where  there  is  an  analysis  of  the  researches  of  Miescher,  and  several  other  authors. 

3  Dorsey's  Elements  of  Surgery.  Philadelphia  Med.  and  Phys.  Journ.  &c.  The  os  humeri 
upon  which  this  experiment  was  first  tried,  and  which  shows,  very  satisfactorily,  the  state  of 
union,  has  been  deposited  in  the  Anatomical  Museum,  by  Mrs.  Randolph,  the  daughter  of 
Dr.  Physick.  The  hole  is  still  left  which  the  seton  occupied. 


BOOK  I. 

PART  II. 
OF  THE  BONES,  INDIVIDUALLY. 

THE  several  textures  of  the  body  are  so  intermixed  that  the  con- 
sideration of  one  alone,  pursued  through  all  its  applications,  excludes 
for  the  time,  rather  artificially,  some  one  or  more  of  the  others.  This 
circumstance,  inseparable  from  a  clear  account,  has  always  perplexed 
writers  on  anatomy,  and  left  them  under  various  impressions  concerning 
the  best  point  of  departure  and  method  for  pursuing  their  descriptions. 
Reasons  of  value  may  be  urged  for  almost  any  arrangement  :  each  one 
•will  have  some  peculiar  advantages  that  the  others  have  not,  and  which 
will  cause  it  to  appear  to  the  understandings  of  its  advocates  superior 
to  the  rest.  For  a  course  of  study  which  is  intended  to  be  physiologi- 
cal and  surgical  in  its  combinations,  the  usual  practice  of  beginning 
with  the  skeleton  is,  perhaps,  the  most  advantageous ;  the  young 
student  will,  however,  understand,  that  if  the  skeleton  have  any  natural 
claim  to  this  precedence,  it  is  principally  from  its  furnishing  those 
landmarks,  as  it  were,  to  which  we  refer  the  situation  of  other  parts, 
and  that  it  is  only  conceded,  for  the  purpose  of  laying  a  foundation  for 
their  more  easy  and  intelligible  description  subsequently.  The  human 
frame  may  be  compared  to  an  extended  landscape,  the  multiplicity  of 
whose  features,  and  the  variety  of  objects  spread  over  whose  surface, 
collectively,  bewilder  the  beholder ;  but  by  seizing  first  on  its  promi- 
nent outlines,  marking  the  course  of  its  mountains  and  ridges,  and 
determining  the  bearings  of  the  several  objects  according  to  them,  we 
become  able,  at  length,  to  define  not  only  to  ourselves,  but  to  others, 
the  precise  position  of  each  point,  or  each  object  which  may  be  the 
subject  of  inspection. 

Unfortunately,  the  minuteness  with  which  the  skeleton  is  described, 
has  been  decried  as  useless ;  but  the  zealous  and  reasonable  student 
ought  to  bear  in  mind,  that  the  only  rational  plan  of  reducing  a  dis- 
located joint  must  depend  upon  a  proper  knowledge  of  its  articular 
faces ;  that  many  of  the  great  phenomena  of  life  depend  essentially 
upon  the  arrangement  of  the  skeleton ;  that  locomotion  is  inseparably 
connected  with  it ;  and  that,  in  short,  it  has  a  bearing  upon  almost 
every  animal  operation.  With  these  facts  impressed  upon  him,  he  will 


106  SKELETON. 

be  prepared  to  give  the  description  of  the  skeleton  a  full  and  perfect 
attention. 

It  is  generally  agreed  to  view  the  following  bones  as  distinct : — 

For  the  Trunk. — Twenty-four  true  or  movable  vertebrae,  one  sacrum, 
four  caudal  vertebrae  or  bones  of  the  coccyx,  two  innominata,  twelve 
ribs  on  each  side ;  a  sternum,  in  three  pieces,  however,  in  the  youthful 
adult— 56. 

For  the  Head — An  occipital  bone,  a  frontal,  a  sphenoidal,  an  eth- 
moidal,  two  parietal,  two  temporal,  each  containing  the  small  bones 
of  the  tympanum ;  two  superior  maxillary,  two  palate,  two  malar  or 
zygomatic,  two  nasal,  two  unguiform  or  lachrymal  bones,  two  inferior 
turbinated,  a  vomer,  and  an  inferior  maxillary — 22. 

One  hyoid,  in  three  pieces,  sometimes  five  in  the  adult,  and  situated 
in  the  throat. 

The  remaining  bones  compose  the  limbs,  and  are,  therefore,  in  pairs, 
or  correspond  exactly  on  the  two  sides  of  the  body.  They  are, 

For  the  upper  Extremities. — The  clavicle,  the  scapula,  the  os  humeri,  < 
the  radius,  the  ulna,  the  eight  bones  of  the  carpus,  the  five  bones  of  the 
metacarpus,  the  two  phalanges  of  the  thumb,  the  three  phalanges  of 
each  of  the  fingers,  the  two,  and  sometimes  more,  sesamoid  bones — 34 
for  each,  68  in  both. 

For  the  lower  Extremities. — The  os  femoris,  the  tibia,  the  fibula,  the 
patella,  the  seven  bones  of  the  tarsus,  the  five  of  the  metatarsus,  the 
two  phalanges  of  the  big  toe,  the  three  phalanges  of  each  of  the  smaller 
toes,  and  the  two,  sometimes  more,  sesamoid  bones — 32  in  each,  64  in 
both. 

There  are,  therefore,  twenty-two  bones  to  the  head,  not  including 
those  of  the  tympanum ;  fifty-six  to  the  trunk  of  the  body ;  one  insulated 
bone  to  the  throat ;  sixty-eight  to  the  two  upper  limbs ;  and  sixty-four 
to  the  two  lower  limbs.  In  all,  two  hundred  and  eleven.  The  redun- 
dancy or  the  deficiency  of  the  sesamoid  bones,  in  a  subject,  may  cause 
this  number  to  be  slightly  increased  or  diminished ;  the  rule  is  also 
variable,  depending  upon  the  particular  views  of  anatomists,  for  some 
make  but  one  bone  of  the  os  occipitis  and  the  os  sphenoides,  and  others 
include  the  teeth. 


CHAPTER  I. 
THE  TRUNK. 

THE  trunk  is  constituted  by  the  Spine,  the  Thorax,  and  the  Pelvis. 

SECT.    I. — THE   SPINE. 

The  Spine  (Columna  Vertebralis,  Rachis)  is  placed  at  the  posterior 
part  of  the  trunk,  and  extends  from  the  head  to  the  inferior  opening 


THE  SPINE. 


10T 


10- 


of  the  pelvis.     It  consists  of  twenty-eight  Fig.  20. 

or  twenty-nine  distinct  pieces,  of  which  the 
upper  twenty-four  are  named  true,  or  mov- 
able vertebrae,  from  the  twisting  motion  they 
execute.  The  twenty-fifth  is  the  sacrum, 
or  the  pelvic  vertebra,  which  is  fixed ;  and 
the  remaining  three  or  four  pieces  are  the 
caudal  vertebras  or  the  coccyx.  The  sa- 
crum and  the  coccyx  are  called  false  ver- 
tebrae, from  not  turning. 

There  are  seven  vertebrae  to  the  neck, 
designated  Cervical ;  twelve  to  the  thorax, 
called  Dorsal ;  and  five  to  the  loins  named 
Lumbar.  In  numbering  the  vertebrae,  the 
one  next  to  the  occiput  is  always  the  first ; 
and  so  on,  successively,  to  the  last.  Albi- 
nus,  however,  has  departed  from  this  rule, 
and  counts  them  from  below  upwards. 

On  the  posterior  face  of  the  spine,  each 
of  the  true  vertebrae  is  seen  to  contribute, 
by  a  long  process,  to  that  ridge  which  is 
so  readily  felt  beneath  the  skin,  and  from 
which,  probably,  the  name  of  spine  was 
derived.  The  spine  increase's  gradually 
in  size  from  the  first  to  the  last  true  ver- 
tebra. The  upper  part  of  the  sacrum  is 
extended  laterally  much  beyond  the  latter, 
afterwards  the  spine  diminishes  abruptly 
to  the  extremity  of  the  coccyx.  The  spine 
has  several  curvatures,  which  are  best 
marked  in  the  erect  position.  For  exam- 
ple, the  lower  part  of  the  cervical  portion 
is  convex  anteriorly,  and  concave  behind  ; 
the  thoracic  part  is  concave  in  front,  and 
convex  behind  ;  the  lumbar  portion  is  con- 
vex in  front,  and  concave  behind  ;  the  pel- 
vic and  caudal  portion  is  concave  in  front, 
and  convex  behind.  This  arrangement -is 
the  result  of  the  different  degrees  of  thick- 
ness in  the  bodies  of  the  vertebrae,  and  es- 
pecially in  the  fibro-cartilages  which  unite 
them  to  each  other.  Wherever  these  car- 
tilages are  thin  at  their  anterior  margin, 
there  is  a  concavity ;  but  .where  they  are 

thick    at    the     Same    point,    there    is    a    COn-          The  middle  plane  of  the  Spinal  Co- 
•.TOYittr  lumn,  showing  its  curvatures  and  in- 

\eXliy.  ternal  structure.— 1.  Atlas.    2.  Den- 

tata.    3.  Seventh   cervical   vertebra. 

4.  Twelfth  dorsal  vertebra.    5.  Fifth  lumbar  vertebra.    6.  First  piece  of  sacrum.     7.  Last  piece  of 
sacrum.    8.  Coccyx.    9.  A  spinous  process.     10,  10.  Intervertebral  foramina. 


1,08  SKELETON. 

General  Characters  of  a  Vertebra. 

A  vertebra  (vertebre)  consists,  in  a  body,  in  seven  processes  or  ex- 
tremities, and  in  a  canal  or  foramen  for  lodging  the  spinal  marrow. 

The  body  of  a  vertebra  is  at  its  fore  part;  its  circumference  is  cylin- 
droid  or  oval,  but  varies  considerably  from  these  figures  according  to 
its  position  in  the  spine.  The  anterior  part  of  the  body  is  convex  ; 
but  the  posterior  part  is  concave,  where  it  contributes  to  the  spinal 
canal.  The  superior  and  inferior  surfaces  are  flat,  with  the  exception 
of  a  ridge  of  hard  bone  at  the  circumference,  more  elevated,  and  not 
so  extended  in  some  bones  as  in  others.  These  ridges  are,  in  young 
subjects,  epiphyses.  There  are  many  foramina,  large  and  small,  to  be 
seen  on  the  front  and  back  surfaces  of  the  bodies.  They  transmit 
arteries  and  veins,  and  are  also  used  for  fastening  the  ligaments  of 
the  spine.  On  the  posterior  face  of  the  body  there  are  two  foramina 
larger  than  the  others,  and  disposed  to  have  a  common  outlet ;  they 
are  occupied  by  veins  coming  from  the  interior  of  the  vertebra.  These 
veins  correspond  with  the  diploic  sinuses  in  the  head,  and  have  been 
particularly  described  by  M.  Breschet,  of  Paris,  in  a  thesis  presented 
to  the  School  of  Medicine,  in  1819. 

The  processes  are  placed  at  the  posterior  part  of  a  vertebra.  Of 
these  there  are  four  oblique  or  articulating  processes,  two  above  and 
two  below,  which  articulate  with  the  corresponding  ones  of  the  adjoin- 
ing bones,  above  and  below ;  two  transverse  processes,  which  project, 
one  on  either  side,  from  between  the  oblique  processes ;  and  one  spin- 
ous  process,  which  is  placed  on  the  middle  of  the  bone  behind.  The 
two  oblique,  and  the  transverse  processes  on  each  side,  come  from  a 
common  base  or  root  that  arises  from  the  lateral  posterior  part  of  the 
body,  and  they  present  collectively  a  very  irregular  appearance.  Their 
faces  and  inclinations  are  much  modified  in  the  several  vertebrae.  The 
spinous  process  is  also  much  modified  in  regard  to  size,  shape,  and  in- 
clination. 

The  body  and  processes  form  the  periphery  of  the  foramen  for  the 
spinal  marrow,  and,  by  their  thickness  and  strength,  afford  an  excel- 
lent protection  to  the  latter.  This  spinal  foramen  is  of  a  rounded 
cylindrical,  or  of  a  triangular  prismatic  shape,  presenting  its  base  in 
front  and  its  apex  behind.  It  is,  for  the  most  part,  considerably  larger 
than  the  spinal  marrow  of  the  part,  including  its  vessels,  membranes, 
and  the  nerves  that  proceed  from  it ;  in  this  respect,  the  foramen  differs 
very  materially  from  the  cavity  of  the  cranium,  which  is  exactly  filled 
by  the  brain. 

At  the  upper  part  of  the  spinal  foramen  of  a  vertebra,  between  the 
body  and  the  upper  articulating,  or  oblique  process,  is  a  groove  or  notch. 
There  is  another  groove  between  the  lower  oblique  process  and  the 
body.  These  grooves,  by  the  approximation  of  the  contiguous  verte- 
brae, are  converted  into  perfect  holes,  called  inter-vertebral  foramina, 
and  are  for  the  transmission  of  the  spinal  nerves  and  blood-vessels. 

The  bodies  of  the  vertebrae  are  extremely  light  and  spongy,  being 


THE  SPINE.  109 

formed  principally  of  the  cellular  texture  or  matter  of  bone,  and  are 
covered  with  a  very  thin  lamella  of  compact  substance,  with  the  ex- 
ception of  their  upper  and  lower  surfaces,  where  this  covering  is  thick 
at  the  circumference,  owing  to  the  epiphyses.  The  processes,  for  the 
most  part,  have  a  thick  and  compact  structure,  enabling  them  to  sus- 
tain conveniently  the  weight  of  the  body  and  the  action  of  the  differ- 
ent muscles,  as  applied  to  them. 

Of  the  Cervical  Vertebras. 

Common  Characters. — The  cervical  vertebrae  differ  among  them- 
selves, but  are  easily  distinguished  from  the  other  bones  of  the  spine. 
Thus  their  bodies  and  processes  are  small,  but  the  spinal  foramen  is 
prismatic  and  large,  so  as  to  admit  of  much  motion,  without  pressing 
on  the  spinal  marrow.  The  fore  and  back  parts  of  the  body  are  more 
flattened.  The  upper  face  is  concave  transversely,  being  bounded  on 
each  side  by  a  ridge  of  bone ;  the  lower  face  is  concave  from  before  back- 
wards, and  is  bounded  by  a  ridge  before  and  behind.  This  arrange- 
ment permits  the  bodies  of  adjoining  vertebrae  to  embrace  each  other 
in  the  dried  bones,  grants  great  facility  of  motion,  in  the  living  body, 
by  the  interposition  of  a  thick  inter-vertebral  substance,  and  obtains 
security  in  the  attachment  of  the  latter. 

The  oblique  processes  have  their  articular  faces  at  an  angle  of  about 
forty-five  degrees;  the  superior  face  upwards  and  backwards,  the  infe- 

Fig.  21. 


The  general  characters  of  a  Cervical  Vertebra.— 1.  Upper  face  of  the  body.  2.  Spinal  canal.  3. 
Half  of  an  intervertebral  foramen.  4.  Bifid  spinous  process.  5.  Bifid  transverse  process.  6.  Verte- 
bral foramen.  7.  Superior  oblique  process.  8.  Inferior  oblique  process. 

rior  downwards  and  forwards.  The  spinous  process  is  short,  triangular, 
nearly  horizontal,  or  slightly  inclined  downwards,  and  bifurcated  at 
its  posterior  extremity,  where  it  terminates  in  one  or  two  tubercles. 
The  transverse  processes  are  short,  and  perforated  by  a  large  canal 
for  the  transmission  of  the  vertebral  artery  and  vein;  they  are  ex- 
cavated above,  somewhat  convex  below,  and  present  two  points  at  their 
external  extremities  for  the  origin  and  insertion  of  muscles.  The 
inter-vertebral  foramen  is  formed  principally  by  the  lower  of  the  two 
contiguous  vertebras,  but  the  difference  in  the  contribution  of  the  two 
is  inconsiderable,  and  is  liable  to  variations  in  different  skeletons,  and, 
indeed,  on  the  bones  of  the  same  set. 


110  SKELETON. 


Of  the  Cervical  Vertebras,  individually. 

The  first  cervical  vertebra,  commonly  called  the  Atlas,  from  its  sup- 
porting the  head,  presents  the  appearance  of  a  large  irregular  ring 
much  thicker  at  its  sides  than  elsewhere.  It  is  defective  in  body, 
owing  to  the  space  allotted  to  that  part  in  the  other  vertebrae  being 
occupied  by  the  processus  dentatus  of  the  second  vertebra.  The  body 
is  represented  by  an  arch  of  bone. 

Its  oblique  processes  are  peculiar  both  in  shape  and  position.  The 
upper  ones  are  concave  and  horizontal,  their  long  diameters  being 
extended  from  within  outwards  and  backwards,  so  as  to  suit  the  direc- 
tion of  the  condyles  of  the  occipital  bone  with  which  they  articulate ; 
the  greatest  depth  of  their  concavity  is,  therefore,  internal.  The 
inferior  oblique  processes  are  smaller,  slightly  concave,  and  circular; 
they  rest  upon  the  shoulders  of  the  second  vertebra.  At  the  internal 
margin  of  the  oblique  processes,  a  rounded  tubercle  is  found  on  either 
side  of  the  bone.  The  transverse  ligament  of  this  vertebra  is  extended 
between  the  two  tubercles,  and  keeps  the  processus  dentatus  in  its  place. 

The  short  thin  bridge,  or  arch,  at  the  fore  part  of  the  bone,  is 
marked  in  front  by  a  tubercle  and  behind  by  an  articular  face  which 
touches  the  processus  dentatus.  The  bridge,  or  section  of  the  ring 
forming  the  posterior  part  of  the  bone,  is  much  longer  and  more  arched 
than  the  anterior.  It  also  has  in  its  centre  a  tubercle,  occupying  the 
position  of  a  spinous  process.  At  the  anterior  extremity  of  this  bridge, 
just  behind  the  upper  oblique  process,  there  is  a  groove,  and  sometimes 
a  canal,  made  by  the  vertebral  vessels  just  before  they  enter  the  fora- 
men magnum  occipitis. 

The  transverse  processes  of  this  vertebra  are  at  the  sides  of  the 
thick  part  of  the  ring.  From  their  greater  length,  they  project  con- 
siderably beyond  the  transverse  processes  below,  and  are  also  perforated 
at  their  bases  by  the  vertebral  vessels,  which  have  a  very  winding 
course  from  them  into  the  cranium. 

The  spinal  canal  of  the  first  vertebra,  excluding  the  space  for  the 
processus  dentatus  and  transverse  ligament,  is  the  largest  in  the  spine; 
by  which  ample  provision  is  made  against  injuries  of  the  medulla 
spinalis,  notwithstanding  the  great  latitude  of  the  rotation  of  this  bone 
upon  the  second  vertebra.  A  considerable  vacuity  is  left  between  the 
upper  posterior  margin  of  the  atlas  and  the  contiguous  surface  of  the 
os  occipitis,  for  the  ginglymoid  motion  of  the  head  upon  the  atlas. 

The  second  vertebra  of  the  neck  (vert,  dentata)  is  particularly  re- 
markable for  the  elongation  of  its  body  above  into  the  processus  dentatus 
or  tooth-like  process.  This  process  rises  as  high  as  the  superior  mar- 
gin of  the  atlas,  and  almost  touches  the  anterior  margin  of  the  foramen 
magnum  occipitis.1  It  presents  an  articular  face  in  front  where  it 
touches  the  first  vertebra.  It  presents  also  a  smooth  face  behind  where 
it  touches  the  transverse  ligament.  Above  the  latter  face,  on  each 
side,  is  a  flat  surface  for  the  origin  of  the  moderator  ligament,  and  the 

!  Sometimes  it  even  forms  a  joint  with  it. 


THE  SPINE.  Ill 

very  point  above  presents  a  small  rou^h  surface  for  the  vertical  liga- 
ment going  to  the  margin  of  the  foramen  magnum. 

On  each  side  of  the  tooth-like  process,  this  bone  presents  its  superior 
oblique  process,  as  a  shoulder,  nearly  horizontal,  circular,  and  some- 
what convex.  The  inferior  oblique  process  has  nothing  peculiar  either 
in  its  position  or  direction.  The  foramen  of  the  transverse  process  is 
directed  upwards  and  outwards.  *  The  interior  part  of  the  body,  like 
that  of  the  other  vertebrae,  is  cellular. 

The  posterior  part  of  the  second  vertebra  is  strong  and  broad.  The 
spinous  process  is  longer  than  any  other,  except  the  seventh  and  some- 
times the  sixth :  it  is  also  much  larger,  is  triangular,  presents  a  ridge 
above  and  a  fossa  below,  and  is  bifurcated  at  its  extremity.  Just  be- 
hind the  upper  oblique  process  there  is  a  very  superficial  notch,  scarcely 
discernible  for  the  inter-vertebral  foramen  which  transmits  the  first 
cervical  nerve.  The  processus  dentatus  is  the  pivot  or  axle  upon  which 
the  head  revolves,  and  is  stationary  while  such  motions  are  going  on. 
The  spinal  canal  of  this  vertebra  is  cordiform  or  circular  instead  of 
triangular. 

The  vertebrae  of  the  neck  increase  gradually  in  the  size  of  their 
bodies  from  the  second  to  the  seventh,  inclusive ;  and  there  is  sufficient 
uniformity  between  them,  with  the  exception  of  the  last,  to  render  the 
general  description  applicable,  though  it  is  not  difficult  to  observe  some 
minute  and  unimportant  points  of  difference. 

Fig.  22. 


A  lateral  view  of  the  Cervical  Vertebrae.— 1.  Atlns.  2.  Processus  dentatus  of  the  second  vertebra. 
3.  Its  superior  oblique  process.  4.  Its  spinous  process.  5,6.  Upper  and  lower  oblique  processes 
showing  their  inclination.  7.  Last  cervical  vertebra. 

The  spinous  process  of  the  sixth  vertebra  is  long,  and  terminates  in 
a  sharp  point  frequently. 

The  seventh  cervical  (vertebra  prominens]  looks  like  a  dorsal  vertebra, 
and  has  some,  peculiarities  which  are  well  marked.  Its  body  is  larger, 


112 


SKELETON. 


its  superior  face  is  less  concave  than  in  the  others,  and  its  inferior  face 
is  flat.  Its  spinous  process  is  the  longest  of  all,  is  not  bifurcated,  but 
terminates  by  a  rounded  tubercle  easily  felt  beneath  the  skin.  Its 
transverse  processes  are  thrown  somewhat  backwards,  and  though  there 
is  a  small  foramen  in  them,  it  is  not  large  enough  to  receive  the  ver- 
tebral vessels.  Sometimes  on  the  side  of  its  body,  at  the  lower  margin, 
is  a  small  face,  by  which  it  partially  articulates  with  the  head  of  the 
first  rib. 

M.  Portal1  reports  that  in  some  rare  cases  he  has  seen  only  six,  and 
in  others,  eight  cervical  vertebrae ;  either  of  which  deviations  I  have 
never  met  with. 


Of  the  Dorsal  Vertebrae. 

G-eneral  or  Common  Characters. — The  dorsal  vertebrae,  amounting 
to  twelve,  being  intermediate  in  position  to  those  of  the  neck  and  loins, 
are  also  intermediate  in  size. 

Their  bodies  are  more  cylindroid  than  those  of  the  neck,  and  the 
most  of  them  are  marked  laterally  on  the  upper,  and  also  on  the  lower 

Fig.  23. 


A  lateral  view  of  the  twelve  Dorsal  Vertebrae.— 1.  First  dorsal  vertebra.  2.  Twelfth  dorsal  ver- 
tebra. 3.  A  spinous  process.  4.  Articulating  face  for  the  head  of  a  rib.  5.  Articulating  face  for  the 
tubercle  of  a  rib.  6.  Superior  oblique  process.  7.  Inferior  oblique  process. 

1  Anat.  Medicale,  Paris,  1803. 


THE  SPINE.  113 

margins,  near  the  base  of  the  processes,  with  a  small  articular  face, 
which  receives  one-half  of  the  head  of  the  adjoining  rib.  The  adjoin- 
ing fossa  of  the  contiguous  vertebrae  receives  the  other  half  of  the 
head  of  the  same  rib. 

The  superior  of  these  articular  faces  is  larger  than  the  inferior. 
The  superior  oblique  processes  are  flat,  and  present  almost  backwards; 
the  inferior  are  also  flat  and  present  as  directly  forwards.  The  trans- 
verse processes  are  directed  diagonally  backwards:  they  are  long,  ter- 
minate in  an  enlarged  extremity,  which  presents  an  articular  face  in 
front  for  the  tubercle  of  the  contiguous  rib.  The  spinous  processes  are 
long,  triangular,  with  a  broad  base,  and  an  extremity  somewhat  rough, 
swollen,  and  sharp-pointed,  except  in  the  upper  and  lower  vertebrae: 
they  have  a  ridge  above  and  a  fossa  below;  are  directed  obliquely 
downwards,  and  overlap  each  other. 

The  spinal  foramen  is  small  and  round.  The  notch  for  the  inter- 
vertebral  foramen  is  formed  principally  by  the  upper  of  the  two  con- 
tiguous vertebrae. . 

Of  the  Dorsal  Vertebrse — individually. 

These  vertebrae  diminish  in  the  transverse  diameter  of  their  bodies 
from  the  first  to  the  third;  afterwards,  they  increase  regularly  in  size 
to  the  last.  The  transverse  processes  of  the  vertebrae  below  are  di- 
rected more  backwards,  and  diminish  in  length.  Though  these  vertebrae 
have  many  common  points  of  resemblance,  yet  some  of  them  present 
distinguishing  peculiarities.  Of  which,  the  first  and  the  two  or  three 
last,  are  the  most  remarkable  examples. 

The  first  has  a  complete  articular  face  on  the  side  of  its  body  for 
the  head  of  the  first  rib,  and  a  partial  surface  at  its  lower  margin  for 
the  head  of  the  second  rib.  Its  spinous  process  is  projecting  and  does 
not  present  so  obliquely  downwards  as  some  of  the  others :  the  flatness 
of  its  body  makes  it  look  much  like  a  cervical  vertebra. 

The  three  lower  dorsal  vertebrae  approach  in  the  form  of  their  bodies 
to  those  of  the  loins.  Frequently,  but  not  always,  the  tenth  has  the 
articular  face  for  the  head  of  the  rib  equi-distant  from  its  upper  and 
lower  margins,  and  its  transverse  process  so  short,  and  inclined  back- 
wards, that  the  tubercle  of  the  tenth  rib  does  not  form  an  articulation 
with  it.  The  eleventh  and  twelfth  vertebrae  have  the  fossae  for  the 
heads  of  the  ribs,  in  their  middle,  at  the  sides  of  the  roots  of  the  pro- 
cesses, instead  of  a  partial  pit  at  their  upper  and  lower  margins. 
Their  transverse  processes  are  remarkably  short,  are  directed  almost 
backwards,  and  do  not  touch  the  ribs,  and  have,  therefore,  no  articular 
marks.  The  spinous  process  departs  from  the  triangular  shape,  be- 
comes flattened  and  vertical  at  its  sides,  is  not  far  from  being  horizontal, 
and  has  a  tubercle  at  its  extremity. 

The  middle  vertebrae  of  the  back  have  some  minute  points  of  differ- 
ence among  themselves,  the  most  of  which  it  would  be  useless  to  study. 
Their  spinous  processes  are  very  near  to,  and  overlap  each  other,  like 
shingles  on  the  roof  of  a  house. 
VOL.  I. — 8 


114  SKELETON. 

Of  the  Lumbar  Vertebrae. 

Common  Characters. — Their  number  has  been  stated  at  five.  Their 
bodies  are  larger  than  those  of  the  other  true  vertebrae,  and  are  of  an 
oval  outline  on  the  upper  and  lower  surfaces,  with  the  long  diameter 
transverse.  The  epiphyses  at  the  margins  of  these  faces  are  larger 
and  more  elevated.  The  spinal  foramen  is  triangular  and  more  capa- 
cious than  in  the  dorsal  vertebrae.  The  inter-vertebral  notches  for  the 

Fig.  24. 


A  lateral   view  of  the  five  Lumbar  Vertebrae. — 1.  First  lumbar.    2.    Superior  oblique   process. 
3.  Spinous  process.    4.  Inferior  oblique  process.    5.  Last  lumbar  vertebra. 

nerves  to  pass  out,  are  much  larger  than  elsewhere  in  the  spine,  and 
are  formed  principally  by  the  upper  of  the  two  contiguous  vertebrae. 

The  transverse  processes  are  very  long,  and  stand  out  nearly  at  right 
angles  to  the  body.  The  articular  faces  of  the  upper  oblique  processes 
are  concave  and  vertical,  being  directed  very  much  inwards,  or  looking 
towards  each  other ;  the  lower  oblique  processes  are  convex,  and  have 
the  articular  faces  directed  very  much  outwardly.  The  spinous  pro- 
cess is  short,  thick,  and  horizontal ;  having  broad,  flat  sides,  and  termi- 
nating by  an  oblong  tubercle  somewhat  bifid  below. 

Of  the  Lumbar  Vertebrae,  individually. 

These  bones  are  not  so  well  marked  among  themselves  as  the  other 
vertebrae.  They  may  be  distinguished  in  a  single  set,  by  the  success- 
ive increase  in  the  size  of  their  bodies.  The  first,  therefore,  is  known 
by  its  being  the  smaller,  by  the  comparative  shortness  of  its  transverse 
process,  and  by  the  .deep  concavity  between  the  superior  oblique  pro- 
cesses. 

The  transverse  and  spinous  processes  of  the  three  middle  vertebrae 
are  rather  longer  than  those  of  the  others;  the  third  has  them  the 
longest  of  all.  The  last  lumbar  vertebra  may  be  recognized  by  its 


THE  SPINE.  115 

greater  size ;  by  its  body  being  flat,  and  thicker  in  front  than  behind, 
so  as  to  give  it  somewhat  of  a  wedge  shape ;  by  the  greater  size  of  its 
spinal  foramen;  by  the  obliquity  backwards  of  the  transverse  process; 
and  by  the  wide  interval  between  the  oblique  processes,  as  well  as  by 
the  lower  of  the  latter  facing  almost  directly  forwards. 

Of  the  Pelvic  Vertebrae. 

The  os  sacrum  (sacrum],  the  largest  by  much  of  any  of  the  bones 
in  the  spinal  column,  has  obtained  its  name  from  the  supposition  of  its 
having  been  offered  in  sacrifice  by  the  ancients.1  It  forms  the  pos- 
terior and  superior  boundary  of  the  pelvis,  as  well  as  the  pedestal  of 
the  spine,  and  may,  therefore,  be  properly  studied  along  with  either  of 
them,  though  its  association  with  the  spine  is  more  natural.  In  its 
lateral  boundaries  it  is  triangular :  it  is  also  regularly  concave  before, 
and  very  irregularly  convex  behind. 

In  its  forming  state,  this  bone  consists  of  five  pieces,  separated  by 
long  narrow  interstices  filled  with  cartilage.  It  is  in  this  condition 
that  its  pieces  bear  strong  resemblance  to  the  true  vertebrae,  and, 
therefore,  have  obtained  the  name  of  false  vertebrae.  They  are  all 
joined  into  one  "by  the  progress  and  development  of  the  bone;  but 
the  marks  of  the  original  separation  remain,  particularly  on  its  front 
surface. 

Though  the  anterior  face  of  the  sacrum  generally  presents  a  regular 
concavity,  in  some  subjects  it  is  almost  flat.  This  surface  is  pierced 
on  each  side  by  four  holes,  which  communicate  with  the  spinal  cavity 

Fig.  25. 


An  anterior  view  of  the  Sacrum.  1.  Articular  face  for  the  last  lumbar  vertebra.  2.  Articular  face 
for  the  coccyx.  3.  Promontory  of  the  sacrum.  4.  Line  marking  the  former  pieces  of  the  sacrum.  5. 
The  first  sacral  foramen.  6.  The  fourth  sacral  foramen.  7.  A  portion  of  the  sacro-sciatic  notch.  8. 
Wing  of  the  sacrum.  9.  Oblique  processes  for  articulating  with  the  last  lumbar  vertebra.  10.  Line  of 
separation  of  the  last  pieces  of  the  bone. 

and  transmit  the  anterior  nerves  of  the  cauda  equina.  Beneath 
each  range  of  holes  is  a  notch,  which,  by  the  corresponding  one  of 
the  coccyx,  is  converted  occasionally  into  a  perfect  foramen  for  the 
thirtieth  spinal  nerve,  or  for  the  fifth  of  the  sacrum.  These  foramina 

1  Portal,  Anat.  Med.  vol.  i.  345. 


116  SKELETON. 

diminish  in  size,  from  the  higher  to  the  lower :  their  orifices  are  funnel- 
shaped,  and  directed  obliquely  outwards.  Horizontal  ridges  of  bone, 
marking  the  original  separation  of  the  false  vertebrae,  connect  the  holes 
of  the  two  sides. 

The  false  vertebrae  decrease  in  size  from  above,  which  is  manifested 
by  the  successive  approach  of  the  foramina,  and  of  the  horizontal 
ridges.  The  first  of  them  has  almost  the  same  vertical  diameter  as 
the  last  of  the  loins,  and  sometimes  a  greater  one,  especially  in  the 
male  subject ;  besides  its  large  increase  of  magnitude  by  the  lateral 
extension  of  its  base. 

The  posterior  face  of  the  sacrum  is  very  convex  and  rough,  and  is 
equally  divided  by  its  spinous  processes.  The  processes  belonging  to 
its  three  upper  sections  or  bones  are  for  the  most  part  well  marked, 
and  decrease  in  length  from  the  first.  The  fourth  spinous  process  is 
resolved  into  two  tubercles,  connected  at  their  base,  and  the  fifth  is  fully 
separated  into  two  tubercles,  by  an  angular  fissure,  with  its  base  down- 
wards and  open.  This  fissure,  it  may  be  remarked,  sometimes  invades 
the  fourth  spinous  process,  and  even  the  third,  and  in  some  rare  cases 
runs  the  whole  length  of  the  posterior  surface  of  the  bone,  leaving  a  gap 
from  one  end  to  the  other.  The  upper  margin  of  the  posterior  face 
of  the  sacrum,  or  its  first  bone,  presents  on  each  side  an  oblique  process 
for  articulating  with  the  lower  oblique  processes  of  the  last  lumbar  ver- 
tebra. Just  above  the  upper  spinous  process  is  a  deep  notch,  between 
which  and  the  last  lumbar  vertebra  is  a  very  large  vacuity,  or  gap, 
exposing  the  spinal  canal. 

On  each  side  of  the  spinous  processes  are  also  four  foramina,  smaller 
and  thinner  than  those  in  front,  for  the  passing  of  the  posterior  nerv- 
ous cords  from  the  cauda  equina.  At  their  internal  margins  some 
small  and  obscure  risings  of  bone  are  perceptible,  which  may  be  con- 
sidered the  rudiments  of  oblique  processes.  On  the  outer  side  of  these 
foramina,  there  are  several  more  strongly  marked  tubercles,  corre- 
sponding with  the  transverse  processes  of  the  true  vertebrae,  and  from 
which  the  sacro-iliac  ligaments  arise.  Beyond  these  the  posterior  sur- 
face of  the  bone  slants  very  considerably  to  its  lateral  margin  ;  the 
entire  surface  of  this  slant,  which  is  irregularly  pitted,  being  devoted 
to  the  origin  of  ligamentous  matter  connecting  it  with  the  ilium. 

The  base  of  the  sacrum  presents  in  its  middle  an  oval  surface  for 
articulating  with  the  body  of  the  last  lumbar  vertebra.  Between  this 
surface  and  the  oblique  process  may  be  remarked  the  groove  for  the 
fifth  lumbar  nerve.  The  base  of  the  sacrum  continually  thickens, 
from  the  side  of  the  oval  surface  to  the  place  of  junction  with  the  ilium. 
The  anterior  margin  of  this  expansion  is  continuous  with  the  linea  ilio- 
pectinea ;  the  posterior  margin  is  elevated  at  its  extremity,  is  a  substi- 
tute for  a  transverse  process,  and  is  placed  immediately  below  the 
transverse  process  of  the  last  lumbar  vertebra.  The  point  of  the  sacrum 
is  truncated  where  it  articulates  with  the  os  coccygis. 

The  lateral  face  of  the  sacrum  is  thicker  above  than  below  ;  its  upper 
two-thirds  present  an  irregular  and  somewhat  triangular  articular  face 
for  joining  the  ilium ;  the  lower  third  is  very  thin,  and  contributes  to 
form  the  sacro-sciatic  notch  of  the  pelvis. 


THE  SPINE.  117 

The  spinal  canal  of  the  sacrum  is  triangular,  and  diminishes  continu- 
ally to  its  lower  extremity,  where  it  terminates  by  a  small  orifice,  notched 
behind,  as  mentioned,  and  exposing  the  last  piece  of  the  bone.  The 
foramina  on  the  anterior  and  posterior  surface  of  the  sacrum,  commu- 
nicating with  this  canal,  correspond  strictly  in  their  uses  and  positions 
with  the  inter-vertebral  foramina  of  other  parts  of  the  spine. 

The  sacrum  is  extremely  light  for  its  size,  and  its  texture  is  in  a 
high  degree  spongy  ;  but  its  processes  and  articular  faces  are  quite  as 
compact  as  they  are  in  other  parts  of  the  spine. 

Of  the  Coccyx  or  Oaudal  Vertebrae. 

The  os  coccygis  (coccyx)  resembles  the  sacrum  in  shape  and  texture, 
and  is  so  placed  as  to  continue  forwards  the  line  of  the  curvature  of  the 
sacrum.  It  consists  in  four  small  pieces,  sometimes  only  three,  united 


The  four  bones  of  the  Coccyx.    1.  First  bone.    2,  3.  Processes  to  join  the  sacrum.    4,  5.  The 
notches  to  form  the  foramen  for  the  sixth  sacral  nerve.    6.  The  last  bone  of  the  coccyx. 

to  one  another  by  fibre-cartilaginous  matter,  and  it  corresponds  with 
the  tails  of  animals.  These  pieces,  in  the  progress  of  life,  are  not  only 
anchylosed  together,  but  also  with  the  sacrum ;  so  that  all  the  false 
vertebrae,  from  the  base  of  the  sacrum  to  the  point  of  the  coccyx,  are 
joined  into  a  single  bone. 

The  upper  bone  of  the  coccyx  is  the  largest,  and  is  the  base  of  this 
little  pyramidal  pile ;  it  is  united,  by  its  middle,  to  the  truncated  apex 
of  the  sacrum,  and  its  sides,  moreover,  are,  in  the  perfect  specimen, 
elongated  several  lines  beyond  this  surface  of  contact.  From  the  pos- 
terior surface  of  the  first  bone,  of  the  perfect  coccyx,  a  tubercle  arises 
on  either  side,  which  is  curved  upwards,  and  joins  the  bifurcated  term- 
ination of  the  last  spinous  process  of  the  sacrum  :  between  the  two 
bones  an  inter-vertebral  foramen  is  thus  left  for  the  passage  of  the  fifth 
sacral  nerve  from  the  canal  of  the  sacrum.  Immediately  below  this 
tubercle  is  a  notch,  made  by  the  sixth  sacral  nerve. 

The  remaining  bones  of  the  coccyx  are  much  smaller  than  the  first, 
and  dimmish  successively.  The  surfaces  which  they  all  present  to 
each  other  are  somewhat  concave  in  the  centre.  The  lower  end  of  the 
last  bone  terminates  in  a  rough  point,  to  which  a  cartilage  is  appended. 
These  bones  are  very  spongy  and  light :  their  principal  strength  is  de- 
rived from  a  ligamentous  covering.  To  them  are  attached  the  sacro- 
sciatic  ligaments,  the  coccygsei,  levatores  ani,  and  the  glutaei  magni 
muscles. 


118  SKELETON. 


SECT.  II. — DEVELOPMENT  OF  THE  VERTEBRAL  COLUMN. 

This  column  is  much  longer,  in  proportion  to  the  limbs,  at  birth, 
than  it  is  in  adult  life,  and  upon  it  depends  the  principal  length  of  the 
individual  at  this  period.  The  head  is  always  in  proportion  to  the 
length  of  the  spine.  This  predominance  in  the  head  and  spine  is,  no 
doubt,  connected  with  the  necessity  of  an  early  development  in  the 
nervous,  respiratory,  and  alimentary  systems,  in  order  to  maintain  the 
life  of  the  individual ;  whereas,  the  use  of  the  upper  and  lower  extremi- 
ties being  called  for  only  at  a  more  advanced  period,  their  develop- 
ment is  not  in  proportion.  It  is  remarked,  that  in  adult  life  the  prin- 
cipal difference  in  the  stature  of  individuals  depends  upon  the  length 
of  the  lower  extremities  ;  the  trunk,  including  the  head,  being  of  nearly 
the  same  length  in  all.  This  rule,  however,  like  most  others,  has  nume- 
rous exceptions.  The  spinal  canal  and  the  inter-vertebral  foramina 
are,  also,  proportionably  larger  in  the  foetus. 

The  spine  of  the  foetus  is  but  badly  suited  to  the  purposes  of  stand- 
ing and  walking.  Its  spinous  processes  are  deficient,  in  consequence 
of  which,  the  muscles  which  are  intended  to  keep  it  erect  have  their 
insertions  so  much  in  the  line  of  motion,  that  they  perform  their  part 
very  imperfectly,  and  the  spine  is  continually  bending  forward  from  the 
erect  position.  All  the  transverse  processes  are  also  imperfectly  de- 
veloped, those  of  the  loins  are  particularly  deficient ;  those  of  the  tho- 
rax and  neck  are  less  deficient,  as  in  the  one  case  they  have  to  form  an 
articular  surface  for  the  ribs,  and  in  the  other  to  allow  passage  to  the 
vertebral  artery.  The  bodies  of  the  vertebrae  are  imperfectly  ossified, 
and  are  separated  by  cartilage  from  the  processes.  The  epiphyses,  or 
upper  and  lower  surfaces  of  the  bodies,  are  in  the  state  of  cartilage  : 
the  bodies,  therefore,  are  rounded  both  above  and  below,  whereby  their 
surfaces  of  contact  are  much  reduced  in  extent,  and  the  line  of  support 
to  the  trunk  rendered  much  less  firm.  When,  at  this  age,  the  vertebrae 
are  macerated,  their  bodies  present  themselves  as  small  rounded  tuber- 
cles ;  and  very  nearly  one-half  the  whole  length  of  the  spine  is  made 
up  of  the  cartilaginous  epiphyses  and  the  inter-vertebral  cartilages. 
The  spine,  in  the  foetus,  is  almost  straight,  and  scarcely  presents  at  all 
those  curvatures  for  which  it  is  so  remarkable  in  adult  life.  This  de- 
pends upon  the  rounded  form  of  the  bodies  of  the  vertebrae,  and  the 
sameness  of  thickness  in  the  inter-vertebral  matter  at  its  anterior  and 
posterior  edge. 


SECT.  III. — ON  THE  USES  OF  THE  VERTEBRAL  COLUMN. 

The  vertebral  column  performs  three  important  offices  in  the  animal 
economy.  It  affords  a  secure  lodgment  to  the  spinal  marrow;  is  a 
line  of  support  to  the  trunk,  in  every  variety  of  position  ;  and  is  the 
centre  of  all  its  movements. 

In  standing,  the  spine  also  supports  the  head,  which  it  can  do  very 
conveniently,  from  the  horizontal  direction  of  the  condyles  and  their 
nearly  central  position  on  the  occiput,  and  from  the  head  being  almost 


VERTEBRAL  COLUMN.  119 

in  equilibrium  when  we  stand  erect.  The  volume  of  the  head  is  so 
much  greater  before  the  condyles  than  behind  them,  that  upon  a  super- 
ficial view  one  would  suppose  its  preponderance  in  front  to  be  very  con- 
siderable. This  is,  however,  less  than  it  might  seem  to  be,  for  two 
reasons:  one  is,  that  the  diameters  of  the  head  are  augmented  behind 
the  condyles,  and,  secondly,  it  is  formed  of  solid  matter  there  ;  whereas, 
in  front  a  great  deal  of  it  is  hollow,  for  the  construction  of  the  nose 
and  the  sinuses  bordering  upon  it.  The  head,  though  nearly  balanced 
then,  has  some  preponderance  in  front,  which  is  manifested  by  its  fall- 
ing forwards  whenever  we  sleep  in  the  erect  position,  or  when  the  sud- 
den suspension  of  life  destroys  the  contraction  of  the  muscles  on  the 
back  of  the  neck. 

In  the  lower  orders  of  animals,  the  obliquity  of  the  condyles,  their 
situation  at  one  end  of  the  head,  and  the  great  length  of  the  face, 
acting  as  a  weight  upon  a  long  lever,  have  a  continual  tendency  to 
incline  the  head  downwards,  which  is  only  partially  counteracted  by 
the  largeness  of  the  muscles  and  ligaments  on  the  back  of  the  neck. 

The  horizontal  direction  of  the  condyles,  and  their  location  near  the 
centre  of  the  base  of  the  head,  have  arrested  the  attention  of  natural- 
ists, and  established  for  man  characters  distinguishing  him  from  all 
other  animals,  for  facility  in  maintaining  the  erect  attitude.  Bichat 
happily  observes,  that  from  this  conformation  result  the  following 
peculiarities  in  his  organization :  1.  Less  strength  in  the  muscles  of 
the  neck  than  in  quadrupeds  ;  2.  Less  projection  in  the  occipital  bone, 
where  the  muscles  are  inserted ;  and,  3.  An  imperfect  development  of 
the  ligamentum  nuchse. 

The  thoracic  and  abdominal  viscera,  by  being  placed  in  front  of  the 
spine,  and  without  a  counterpoise  behind,  have  a  continued  tendency 
to  bend  it.  This  is  only  resisted  by  the  muscles  which  fill  up  the  long 
gutter  on  either  side  of  the  spinous  processes,  and  are  inserted  into  the 
ribs,  the  spinous  and  the  transverse  processes.  The  lumbar  vertebrae 
and  the  appertaining  muscles  and  ligaments,  having  an  increased  duty 
to  perform,  from  the  lowness  of  their  position,  and  the  variety  of  their 
movements,  become  the  soonest  affected  by  fatigue  and  bodily  weak- 
ness, and  therefore  manifest  sooner  the  sensation  of  lassitude,  notwith- 
standing the  augmented  volume  of  the  bodies  and  processes  of  these 
vertebrae,  and  of  the  muscular  masses  inserted  into  them. 

The  mechanical  arrangement  of  the  spine  permits  it  to  perform 
the  motions  of  flexion,  extension,  lateral  bending,  circumduction,  and 
rotation. 

1.  Flexion,  or  that  posture  in  which  the  spine  is  bent  forwards,  is 
the  most  extensive  of  its  movements;  the  general  mechanism  of  the 
human  body  disposes  us  to  approach  surrounding  objects  in  that 
direction ;  and  the  muscles  of  the  abdomen,  besides  their  intrinsic 
strength,  act  most  advantageously  in  producing  it,  by  being  removed 
to  a  great  distance  from  the  centre  or  line  of  motion.  In  this  position 
the  inter- vertebral  cartilages  are  diminished  or  compressed  in  front, 
and  thickened  behind ;  the  anterior  vertebral  ligament  is  in  a  state 
of  relaxation,  while  the  posterior  vertebral  ligament,  the  elastic,  and 


120  SKELETON. 

those  which  connect  the  spinous  processes,  are  in  a  state  of  propor- 
tionate tension. 

2.  The  motion  of  extension,  on  the  contrary,  is  much  more  limited 
from  several  causes.     The  muscles  which  act  in  this  case,  by  arising 
either  from  the  posterior  face  of  the  pelvis,  or  from  the  transverse 
processes,  and  going  upwards  to  be  inserted  either  into  the  ribs,  the 
transverse  or  the  spinous  processes,  are  much  less  advantageously  placed 
than  the  abdominal  muscles,  in  regard  to  the  length  of  the  lever  which 
they  employ.     Moreover,  mechanical  obstruction   is  opposed  to  this 
motion  by  the  spinous  processes  of  the  back  and  neck,  being  very  near 
to  and  overlapping  each  other.     The  abdominal  muscles  also  afford  a 
strong  resistance  to  its  being  carried  beyond  a  certain  point  as  any  one 
may  assure  himself  of,  by  the  tension  communicated  to  these  muscles 
from  placing  a  large  billet  of  wood  under  the  loins  of  a  subject ;  and, 
when  they  are  cut  through  transversely,  the  immediate  consequence  is 
a  great  increase  in  the  posterior  flexion  of   the  spine,  through  the 
agency  of  the  lower  dorsal   and  the  lumbar  vertebrae.     The  anterior 
vertebral  and  the  inter-vertebral  ligaments   likewise  oppose  the  ex- 
tension of  the  spine  much  more  than  the  elastic  and  the  inter-spinous 
ligaments  do  its  flexion. 

3.  The  lateral  inclination  of  the  spine  is  a  motion  of  considerable 
extent,  and  is  obtained  both  by  the  very  advantageous  position  of  the 
muscles  on  the  side  of  the  trunk  and  neck,  and  by  the  little  mechanical 
resistance  to  it  from  the  shape  and  arrangement  of  the  parts  concerned. 
A  principal  impediment  to  this  motion  being  carried  beyond  a  certain 
point  is  presented  by  the  ribs  striking  against  each  other.     The  trans- 
verse processes  of  all  the  vertebras  are  so  far  apart,  particularly  in  the 
loins,  that  they  scarcely  deserve  to  enter  into  the  estimate  of  resist- 
ances.    As  the  muscles  of  the  one  side  produce  the  lateral  curvature, 
so  their  resistance  on  the  other  limits  it  to  a  certain  extent,  as  may  be 
readily  ascertained  by  cutting  them  through. 

4.  The  circumduction  of  the  spine  is  that  motion  in  which  the  trunk 
is  caused  to  describe  a  cone,  the  base  of  which  is  above,  and  the  apex 
below.     It  is  performed  on  the  lower  dorsal  and  the  lumbar  vertebrae, 
and  is  a  succession  of  the  movements  already  described. 

5.  The  rotation  of  the  spine  is  a  very  limited  motion.     It  is  per- 
formed almost  entirely  on  the  lower  dorsal  and  the  upper%lumbar  ver- 
tebrae, and  presents  in  its  analysis  a  series  of  minute  and  oblique  slidings 
of  the  bodies  of  the  vertebrae  upon  one  another,  the  pivots  being  the 
oblique  processes.     The   action  occurs  by  the  lateral  yielding  of  the 
inter-vertebral  substance ;   it  must,  therefore,  be  almost  inconceivably 
small  in  any  individual  substance,  particularly  when  the  latter  has  been 
hardened  and  rendered  more  fibrous   by  old  age.     In  the  very  young 
subject  it  is  more  appreciable. 


VERTEBRAL  COLUMN.  121 

Of  the  Motions  peculiar  to  each  Class  of  Vertelrse. 

1.  The  cervical  vertebrae,  as  a  whole,  enjoy  a  considerable  share  of 
flexion,  extension,  lateral  inclination :  and  of  circumduction,  as  the 
result  of  the  other  motions.  Their  rotation,  or  the  oblique  sliding  of 
one  vertebra  upon  the  other,  is  very  limited.  The  apparent  facility 
with  which  they  are  twisted  upon  each  other,  when  the  face  is  turned 
to  the  shoulders  alternately,  is  almost  wholly  the  motion  of  the  first  ver- 
tebra upon  the  second,  the  participation  of  the  other  vertebrae  being  very 
inconsiderable.  The  possibility  of  the  simple  dislocation  of  these  verte- 
brae, with  the  exception  of  the  first,  is  very  stoutly  denied  by  authori- 
ties o"f  the  first  standing  in  anatomy,  on  the  score  that  too  great  a 
resistance  to  this  accident  is  afforded  by  the  inter-spinal  and  inter- 
transverse  muscles,  by  the  inter-locking  of  the  bodies  of  the  vertebras 
through  their  reciprocal  concavities  and  convexities,  and  by  the  shape 
and  extent  of  their  oblique  processes. 

Many  years  ago,  I  met  with  a  case  in  which  there  was  every  reason 
to  believe  that  a  partial  displacement  or  dislocation  had  occurred  about 
the  fourth  vertebra,  in  a  boy  of  eight  or  ten  years.  It  arose  from  his 
struggling  to  extricate  himself  from  the  grasp  of  a  school-mate,  who 
held  him  near  the  ground  by  the  back  of  the  head,  with  the  spine  bent 
forwards.  This  position,  it  is  evident,  was  calculated  to  lift  the  oblique 
processes  of  the  vertebrae  above,  over  the  others;  and  an  oblique  force 
applied  at  the  same  time  consummated  the  accident,  by  twirling  the 
lower  oblique  process  over  the  upper  margin,  and  in  front  of  the  one 
with  which  it  was  articulated  below.  The  displacement  was  manifested 
by  inability  to  move  the  neck ;  by  a  permanent  inclination  and  turn  of 
the  head  to  the  side  opposed  to  the  injured  one ;  and  by  an  inequality 
in  the  range  of  the  anterior  points  of  the  transverse  processes  of  the 
side  affected.  I  succeeded  in  replacing  the  bone  by  lifting  its  dislocated 
side  over  the  oblique  process  of  the  vertebras  below,  communicating  at 
the  same  moment  a  rotatory  motion,  the  reverse  of  that  by  which  the 
accident  had  happened.  In  an  instant,  the  patient  was  relieved:  from 
extreme  pain,  fixed  deformity,  and  inability  to  move  the  neck,  he  per- 
formed with  freedom  all  the  motions  natural  to  the  part.1 

The  principal  motions  of  the  head  upon  the  first  vertebra  are  those 
of  flexion  and  extension  ;  the  power  of  the  condyles  to  slide  horizontally 
from  one  side  to  the  other  in  the  cavities  formed  in  the  atlas  is  narrowly 
restricted,  both  by  the  shape  of  the  proximate  articular  surfaces,  and 
by  the  arrangement  of  the  ligaments:  this  motion  is,  in  fact,  so  incon- 
siderable as  scarcely  to  deserve  notice.  Even  flexion  and  extension 
appear  greater  than  they  actually  are,  in  consequence  of  the  lower  ver- 
tebras most  commonly  concurring  in  these  motions.  When  simply  the 
head  is  flexed  upon  the  atlas,  while  the  other  vertebras  are  kept  erect, 
the  chin  approaches  the  sternum,  and  the  skin  of  the  neck  is  thrown 
into  folds ;  but  when  all  the  bones  are  flexed,  the  head  is  thrown  for- 
wards and  the  skin  is  kept  tense.  The  flexion  of  the  head  upon  the 
atlas  is  restricted  by  the  ligamentum  nuchas,  and  by  the  ligament  pass- 

1  I  have  also  seen  another  accident  of  a  similar  kind  from  a  fall.  See  Med.  Examiner, 
1842. 


122  SKELETON. 

ing  from  the  posterior  margin  of  the  occipital  foramen  to  the  posterior 
bridge  of  the  atlas.  The  extension  of  the  head  is  restricted  by  the  ver- 
tical, moderator,  and  anterior  vertebral  ligaments. 

The  motion  of  the  atlas  upon  the  axis  is  limited  strictly  to  rotation. 
The  confinement  of  the  processus  dentatus  by  the  transverse  ligament 
behind,  and  by  the  anterior  bridge  of  the  first  vertebra  in  front,  pre- 
vents thoroughly  both  flexion  and  extension.  The  horizontal  direction 
and  the  flatness  of  the  corresponding  articular  faces  of  these  two  ver- 
tebrae also  prevent  any  lateral  inclination.  In  compensation  for  these 
restrictions,  the  rotatory  motion  is  enjoyed  to  great  extent,  and  is  amply 
provided  for,  by  the  extreme  looseness  and  thinness  of  the  capsular  liga- 
ment of  the  oblique  processes.  In  this  motion  the  arch  of  the  atlas 
and  the  transverse  ligament  rotate  on  the  tooth-like  process  to  the  right 
and  left  alternately;  at  the  same  time  the  inferior  oblique  process  of 
the  atlas  is  slid  either  forwards  or  backwards,  according  to  the  general 
movement  upon  the  upper  oblique  process  of  the  dentata.  This  move- 
ment is  checked,  at  a  certain  point,  by  the  moderator  ligaments,  which, 
by  the  close  connection  of  the  head  and  first  vertebra,  answer  the  same 
purpose  as  if  they  were  inserted  into  the  latter.  It  is  also  checked  by 
the  capsular  ligament,  notwithstanding  the  general  laxity  of  the  latter. 
But  still  it  is  not  difficult  for  it  to  exceed  its  natural  bounds,  and  for  the 
oblique  process  of  the  atlas  to  pass  completely  beyond  the  margin  of 
that  of  the  dentata,  and  in  returning  to  lock  against  it.  This,  in  fact, 
happens,  in  the  great  majority  of  instances,  where  violence  from  falls, 
and  so  on,  has  been  applied  to  the  body,  and  results  in  injury  to  the 
neck  particularly;  and  when,  in  the  abrupt  turning  of  the  head,  pro- 
duced by  the  action  of  the  muscles,  the  individual  finds  himself  incapa- 
ble of  bringing  it  back.  This  articulation  is,  unquestionably,  less  pro- 
tected, and  more  exposed  to  accident,  than  any  other  in  the  spine ;  and, 
as  just  stated,  is  therefore  supposed,  by  some,  to  be  the  only  one  in  the 
neck  admitting  of  simple  luxation. 

Most  frequently,  in  this  luxation,  when  it  is  produced  by  external 
violence,  death  is  the  immediate  result,  from  the  spinal  marrow  being 
pressed  upon  and  disorganized  above  the  origin  of  the  phrenic  nerve. 
The  seat  of  the  principle  of  respiration  is  in  the  medulla  oblongata, 
and  its  agents  are  the  phrenic  and  the  intercostal  nerves ;  the  commu- 
nication with  which  being  thus  cut  off,  respiration,  and  consequently 
circulation,  stop  immediately.  Bichat  thinks,  that  when  death  is  thus 
suddenly  produced,  the  processus  dentatus,  by  rupturing  its  own  liga- 
ments connecting  it  to  the  occiput,  slides  by  the  falling  of  the  head 
forwards,  beneath  the  transverse  ligament,  and  presses  upon  the  spinal 
marrow.  On  the  contrary,  when  it  is  a  simple  displacement  of  the 
oblique  processes,  as  the  odontoid  process  remains  within  its  boundaries, 
and  its  ligaments  are  only  stretched,  there  is  no  danger  of  death. 
Fatal  accidents  have  happened  to  this  articulation,  in  holding  an  infant 
from  the  ground,  by  the  two  hands  applied  to  the  head,  from  his  strug- 
gles to  disengage  himself.  A  posture-maker  is  said  to  have  died  on 
the  spot,  from  communicating  a  rotatory  motion  to  his  trunk,  while  its 
weight  was  sustained  by  inverting  his  head,  and  making  the  latter  the 
base  of  support.  When  the  vertebrae  are  displaced  in  such  persons, 
as  well  as  in  those  hung  by  the  neck,  it  is  supposed  that  the  sliding  of 


OSSA  INNOMINATA.  123 

the  processus  dentatus  from  beneath  the.  transverse  ligament  takes 
place ;  as,  by  experiments  on  the  dead  body,  it  is  found  that  such  dis- 
placement occurs  much  more  readily  than  the  rupture  of  the  transverse 
ligament. 

2.  The  dorsal  vertebras  are  capable  of  but  very  little  motion  in  any 
direction.     The  rigidity  and  length  of  the  sternum  prevent  their  flexion ; 
the  overlapping  and  obliquity  of  their  spinous  processes  prevent  their 
extension,  and  the  ribs  prevent  their  lateral  inclination.     It  is,  how- 
ever, to  be  observed,  that  as  those  obstacles  are  diminished,  success- 
ively, in  the  five  lower  dorsal  vertebrae,  they  consequently  become  more 
and  more  capable  of  motion  upon  each  other.     Simple  luxation  among 
them,  at  any  point,  is  thought  to  be  impossible,  from  the  strength  of 
their  ligamentous    attachments,  and  from  the  arrangement  of   their 
articular  faces. 

3.  The  lumbar  vertebrae  move  with  great  comparative  freedom  upon 
one  another;  admitting,  as  stated,  of  flexion,  extension,  and  lateral  in- 
clination.    Below,  however,  they  are  much  more  restrained  than  they 
are  above ;  hence,  it  results  that  the  principal  seat  of  the  motions  of 
the  trunk  upon  the  spine  is   about  the  connection   of  the  lumbar  and 
dorsal  vertebrae.     Simple  dislocation  is  here,  also,  thought  to  be  impos- 
sible, from  the  strength  of  their  ligamentous  attachments,  from  the 
great  diameters  of  their  bodies,  and  from  the  deep  inter-locking  of  the 
oblique  processes. 


SECT.  IV. — OF  THE  OSSA  INNOMINATA. 

(Os  Coxaux,  ou  des  lies.) — These  bones,  two  in  number,  are  situated 
one  at  either  side  of  the  sacrum,  and  constitute  the  lateral  and  ante- 
rior parietes  of  the  pelvis ;  forming,  along  with  the  sacrum  and  coccyx, 
the  whole  of  this  latter  cavity. 

The  os  innominatum,  from  having  been,  in  its  original  state,  in  three 
pieces,  notwithstanding  they  subsequently  coalesce  firmly  in  the  adult, 
and  preserve  scarcely  any  vestige  of  their  primitive  distinction,  is 
;  divided  by  anatomists  into  ilium,  ischium,  and  pubes. 

Os  Ilium  (Ilion). — This,  the  largest  of  the  three  portions,  forms  all 
the  upper  rounded  part  of  the  os  innominatum,  and  is  the  haunch  bone 
of  common  language.  Its  external  face  is  called  the  Dorsum,  and  the 
internal  face  the  Costa  or  Venter.  Its  superior  margin  is  a  semicircle, 
rather  thicker  towards  the  extremities  than  in  the  middle.  The  in- 
equality, when  viewed  from  above,  is  very  apparent,  as  well  as  a  slight 
curvature  resembling  the  letter  S.  This  margin  of  the  bone  is  called 
its  crest  or  spine,  presents  an  internal  lip  for  the  origin  of  the  trans- 
versalis  abdominis  muscle,  an  external  one  for  the  insertion  of  the 
obliquus  externus,  and  an  intermediate  edge  for  the  origin  of  the 
obliquus  internus.  The  anterior  extremity  of  the  spine  is  terminated 
by  a  projecting  point,  called  the  anterior  superior  spinous  process,  from 
which  arise  the  tensor  vaginae  femoris,  the  sartorius,  and  the  beginning 


124  SKELETON. 

of  Poupart's  ligament.  The  posterior  extremity  of  the  crest  is  also 
projecting  and  pointed,  but  less  so  than  the  other,  and  obtains  the 
appellation  of  the  posterior  superior  spinous  process. 

The  anterior  margin  of  the  os  ilium  is  unequal,  and  divided  into  two 
portions  of  nearly  the  same  length,  by  a  strong,  well-marked  projection, 
the  anterior  inferior  spinous  process,  which  is  placed  an  inch  and  a-half 
below  the  anterior  superior,  and  gives  origin  to  the  rectus  femoris. 
This  margin  joins  with  the  pubes  by  a  large  flattened  elevation,  called 
the  ilio-pectineal  protuberance.  Between  the  latter  and  the  anterior 
inferior  spinous  process,  a  concavity  exists  which  is  occupied  by  the 
junction  of  the  psoas  magnus  and  the  iliacus  internus  muscles,  where 
they  pass  under  Poupart's  ligament.  Between  the  two  anterior  spinous 
processes  is  another  concavity,  from  which  the  anterior  edge  of  the 
gluteus  medius  arises. 

The  posterior  margin  of  the  ilium  is  also  very  unequal,  both  in  its 
direction  and  thickness.  -  The  posterior  inferior  spinous  process  is 
about  sixteen  lines  below  the  posterior  superior,  and  terminates  a  cut- 
ting edge  running  between  these  two  processes.  Just  below  it  we  find 
the  deep  excavation  called  the  sciatic  notch. 

The  exterior  face  of  the  ilium,  or  its  dorsum,  is  generally  convex  and 
rounded  ;  its  margins,  however,  are  so  elevated  that  partial  depressions, 
or  sinkings  below  the  general  surface,  may  be  remarked,  especially  at 
its  back  part.  Just  above  the  two  posterior  spinous  processes,  a  flat- 
ness is  observable,  from  which  a  part  of  the  gluteus  magnus  arises. 

Fig,  27. 


Outside  of  the  Innominatum  of  the  right  side.  1.  Dorsum  of  the  ilium.  2.  Ischium.  3.  Pubes. 
4.  Crest  of  the  ilium.  5.  Surface  for  the  gluteus  medius.  6.  Surface  for  the  gluteus  minimus.  7. 
Surface  for  the  gluteus  magnus.  8.  Anterior  superior  spinous  process.  9.  Anterior  inferior  spinous 
process.  10.  Posterior  superior  spinous  process.  11.  Posterior  inferior  spinous  process.  12.  Spine 
of  the  ischium.  13.  Greater  sciatic  notch.  14.  Lesser  sciatic  notch.  15.  Tuber  ischii.  16.  Ramus 
of  the  ischium.  17.  Body  of  the  pubes.  18.  Ramus  of  the  pubes.  19.  Acetabulum.  20.  Thyroid 
foramen. 

A  semicircular  rough  ridge  begins  at  or  near  the  anterior  superior 
spinous  process,  and  may  be  traced  on  this  surface  of  the  bone  to  the 


OSSA  INNOMINATA.  125 

sciatic  notch.  All  that  portion  of  the  dorsum  between  this  ridge  and 
the  crest  of  the  bone,  with  the  exception  of  the  little  flat  surface  just 
above  the  posterior  spinous  processes,  gives^origin  to  the  gluteus  medius. 
The  dorsum  terminates  below  at  the  acetabulum,  and  between  the  latter 
and  the  semicircular  ridge  is  the  surface  for  the  origin  of  the  gluteus 
minimus. 

The  internal  face  of  the  ilium,  or  that  portion  which  looks  towards  the 
belly,  being  called  the  costa  or  venter,  is  in  its  superior  part,  amounting 
to  about  two-thirds  of  the  whole  surface,  very  concave.  This  is  the  iliac 
fossa,  which  is  occupied  by  the  iliacus  internus  muscle.  The  fossa  is 
continued  forwards  into  the  hollow  below  the  anterior  inferior  spinous 
process,  and  over  the  acetabulum.  The  iliac  fossa  is  terminated  below 

Fig.  28. 


Inside  of  the  Innominatum  of  the  right  side.  1.  Surface  for  the  sacro-iliac  ligaments.  2.  Ischium. 
3.  Body  of  pubes.  4.  Anterior  superior  spinous  process.  5.  Anterior  inferior  spinous  process.  6. 
Posterior  superior  spinous  process.  7.  Posterior  inferior  spinous  process.  8.  Sciatic  notch.  9. 
Plane  of  the  ischium.  10.  Iliac  fossa.  11.  The  portion  of  the  venter  which  is  continuous  with  the 
wing  of  the  sacrum.  12.  Linea  ilio-pectinea.  13.  Spine  of  ischium.  14.  Tuber  ischii.  15.  Line 
of  attachment  of  the  greater  sacro-sciatic  ligament.  16.  Line  of  attachment  of  the  erector  penis,  or 
clitoridis  muscle.  17.  Syrnphysis  pubis.  18.  Ilio-pectineal  protuberance  or  boss.  19.  Groove  for  the 
obturator  vessels  and  nerve.  20.  Foramen  thyroideum. 

by  a  rounded  ridge,  a  part  of  the  linea  ilio-pectinea  that  separates  the 
greater  from  the  lesser  pelvis.  The  remaining  third  of  the  costa  of 
the  ilium  is  very  rough  and  unequal,  and  is  appropriated  to  the  articu- 
lation with  the  sacrum,  and  to  the  origin  of  some  of  the  muscles  of  the 
back.  Immediately  posterior  to  the  sciatic  notch  is  the  surface  for  the 
sacrum,  which  is  somewhat  triangular,  but  irregularly  so,  and  extends 
from  the  iliac  fossa  to  the  posterior  inferior  spinous  process.  Behind 
the  sacral  surface  is  another,  twice  as  large,  strongly  marked  by  its 
roughness,  and  elevated  into  a  vertical  ridge  near  its  middle.  Anterior 
to  this  ridge  arise  many  of  the  ligamentous  fibres,  fastening  the  ilium 
to  the  sacrum ;  but  posterior  to  it  is  the  surface  for  the  origin  of  the 
multifidus  spinse  and  the  sacro-lumbalis  muscle. 

Os  Pubis  (Pubis). — This  bone  constitutes  the  fore  part  of  the  inno- 
minatum,  and  is  much  the  smallest  of  the  three.     It  is  composed  of  a 


126  SKELETON. 

body  and  two  large  branches  from  it,  one  running  downwards  to  join 
the  ischium,  and  the  other  backwards  and  upwards  to  join  the  ilium. 

The  body  of  the  pubes  is  joined  to  its  fellow  on  the  opposite  side  by 
a  flat  surface,  called  the  symphysis,  which  is  eighteen  or  twenty  lines 
in  its  long  diameter.  The  superior  part  of  the  body  also  presents  a 
flat  surface,  called  its  horizontal  portion,  which  is  bounded  outwardly 
by  the  spinous  process  about  an  inch  from  the  symphysis.  The  hori- 
zontal portion  and  the  symphysis  form  a  right  angle.  From  the 
exterior  face  of  the  spinous  process  two  ridges  proceed  outwardly  ;  the 
posterior  is  the  crista ;  it  is  frequently  sharp,  elevated,  and  makes  the 
anterior  half  of  the  linea  ilio-pectinea  ;  the  anterior  ridge  is  lower  down, 
increases  in  its  elevation  as  it  goes  along,  is  rounded,  and  runs  nearly 
horizontally  to  terminate  in  the  anterior  upper  margin  of  the  acetabu- 
lum.  Between  the  two  ridges  is  a  superficial  triangular  concavity 
occupied  by  the  origin  of  the  pectineus  muscle ;  the  base  of  the  tri- 
angle is  bounded  by  the  protuberance  formed  at  the  junction  of  the 
pubes  and  ilium,  and  it  is  exactly  over  this  part  that  the  femoral 
vessels  pass ;  its  apex  is  the  spine  or  spinous  process  of  the  pubes. 
The  extremity  of  the  upper  branch  of  the  pubes  is  triangular,  and 
much  enlarged  where  it  contributes  to  the  acetabulum. 

The  inferior  branch  of  the  pubes,  technically  called  its  ramus,  is  a 
flattened  process  about  an  inch  in  length,  and,  as  mentioned,  descends 
to  join  the  ischium.  Its  exterior  is  plain,  and  has  no  mark  deserving 
of  attention  ;  but  the  internal  face,  near  the  anterior  margin,  is  con- 
cave for  attaching  the  crus  of  the  penis,  or  of  the  clitoris. 

The  body  of  the  pubes  in  front  is  concave,  and  gives  origin  to  the 
adductor  longus  and  brevis  muscles  :  behind,  it  is  only  sufficiently 
concave  to  participate  in  the  general  concavity  of  the  pelvis. 

Os  Ischium,  (Ischion.) — This  bone  forms  the  posterior  inferior  por- 
tion, of  the  os  innominatum,  and  is  the  next  in  size  to  the  ilium.  It  is 
of  a  triangular  form,  and  has  the  anterior  extremity  bent  upwards  to 
join  with  the  pubes.  The  latter  part  is  its  crus  or  ramus,  and  the 
remainder  is  its  body. 

The  body  of  the  ischium  is  a  triangular  pyramid,  the  internal  side 
of  which  is  smooth  and  uniform,  but  the  posterior  and  the  external 
sides  are  very  unequal.  The  internal  side  is  broad  above  and  narrow 
below  ;  at  the  middle  of  its  posterior  margin  is  the  spinous  process,  a 
projection  of  considerable  magnitude,  and  sharp-pointed,  for  attaching 
the  lesser  sacro-sciatic  ligament.  Immediately  below  the  spinous 
process  is  a  smooth  concave  surface,  forming  a  trochlea,  over  which  the 
obturator  internus  muscle  plays.  Below  this  trochlea,  and  forming  the 
most  inferior  internal  margin  of  the  bone,  is  a  long  ridge,  somewhat 
more  elevated  behind  than  in  front,  into  which  the  great  sacro-sciatic 
ligament  is  inserted.  The  internal  face  of  the  ischium.  though  tech- 
nically called  its  plane,  departs  from  the  perfect  regularity  implied  in 
that  name,  by  participating  in  the  general  concavity  of  the  pelvis. 

The  posterior  face  of  the  ischium  is  swollen  out,  above,  into  a  rounded 
surface,  for  the  strengthening  of  the  posterior  parietes  of  the  acetabu- 
lum. This  swell  is  bounded,  below,  by  a  transverse  depression  or  fossa; 
immediately  below  which,  is  the  tuberosity  of  the  ischium,  a  large 
rough  surface  extending  from  the  fossa  to  the  beginning  of  the  crus. 


OSSA  INNOMINATA.  127 

This  rough  surface  is  subdivided  into  four,  two  above,  and  two  below. 
The  one  above,  which  is  external,  and  nearest  to  the  acetabulurn,  gives 
origin  to  the  semi-membranosus  muscle ;  the  other,  which  is  internal, 
gives  origin  to  the  semi-tendinosus,  and  to  the  long  head  of  the  biceps 
flexor  cruris.  Of  the  two  flat  surfaces  below,  the  one  which  borders 
on  the  ridge  for  the  insertion  of  the  great  sacro-sciatic  ligament,  and 
naturally  covered  with  cartilage,  is  the  part  on  which  we  sit;  and  the 
last  surface,  which  is  exterior  again  to  this,  gives  origin  to  a  part  of 
the  adductor  magnus  muscle. 

The  exterior  face  of  the  ischium,  above,  forms  the  lower  part  of  the 
acetabulum,  and  is,  therefore,  very  much  excavated ;  below  this,  the 
surface  is  flat,  and  sufficiently  uniform  to  dispense  with  a  particular 
description. 

The  crus  of  the  ischium  is  flattened  internally  and  externally,  and  in 
the  adult  it  is  fused  completely  into  the  crus  of  the  pubes,  so  that  very 
faint  marks  of  their  primitive  separation  are  left.  The  anterior  margin 
of  the  crus  has  an  excavation  continuous  with  that  on  the  crus  of  the 
pubes,  for  the  origin  of  the  crus  penis  and  the  erector  penis  muscle. 

In  examining  the  general  features  of  the  os  innominatum,  it  will  be 
observed,  that  its  outline  is  in  some  degree  like  the  figure  8  ;  the  nar- 
rowing in  its  centre  Joeing  produced  by  the  sciatic  notch  below,  and 
by  the  deep  concavity  above,  between  the  anterior  superior  spinous 
process  and  the  symphysis  of  the  pubes.  The  regularly  rounded  margin 
of  the  ilium  above,  and  of  the  ischium  below,  contribute  to  the  resem- 
blance, but  the  angle  of  the  pubes  interrupts  it.  The  narrowest  part 
of  the  bone,  or  its  neck,  is  between  the  top  of  the  sciatic  notch  and  the 
fossa  below  the  anterior  inferior  spinous  process.  It  will  also  be  re- 
marked, that  the  posterior  margin  of  the  sciatic  notch  is  formed  by  the 
ilium,  and  the  anterior  by  the  ischium. 

The  acetabulum,  or  the  cotyloid  cavity  (cavite  cotyloide\  is  placed 
immediately  on  the  outside  of  the  neck  of  the  os  innominatum.  In  in- 
fancy one-fifth  of  it  is  seen  to  be  made  by  the  pubes,  two-fifths  by  the 
ilium,  and  two-fifths  by  the  ischium.  It  is  a  very  deep  hemispherical 
depression,  having  a  sharp  elevated  margin  all  around,  particularly  at 
its  superior  part.  The  inferior  margin,  amounting  to  one-eighth  of 
the  whole  circumference,  is  comparatively  shallow,  and  is,  indeed,  con- 
verted into  a  notch  (incisura  acetabuli),  sunk  much  below  the  general 
surface  of  the  brim.  The  greater  part  of  the  acetabulum  is  smooth, 
and  incrusted  with  cartilage  wherever  the  head  of  the  os  femoris  is  ap- 
plied to  the  support  of  the  trunk;  but  the  very  bottom  (fovea  acetabuli), 
with  the  intervening  surface  continuous  with  the  notch,  amounting  to 
rather  more  than  one-fourth  of  the  whole  cavity,  is  rough,  sunk  below 
the  general  concavity,  and  is  occupied  by  a  soft  vascular  fat. 

In  the  fore  part  of  the  innominatum  a  large  deficiency,  called  the 
thyroid  foramen  (foramen  ihyroideum),  exists  between  the  pubes  and 
ischium.  In  the  male  subject  it  is  triangular,  with  the  angles  rounded ; 
but  in  the  female  it  is  rather  oval.  Leading  from  the  plane  of  the 
ischium  is  a  groove,  which  goes  along  the  superior  end  of  the  foramen, 
and  appears  externally  under  the  anterior  ridge  of  the  pubes.  It  con- 
ducts the  obturator  vessels  and  nerve  to  the  inner  side  of  the  thigh. 


128  SKELETON. 

The  texture  of  the  os  innominatum  is  cellular  within,  with  a  con- 
densed lamella  externally.  It  is  of  very  various  thickness.  The  ilium, 
in  its  centre,  has  the  dorsal  or  the  external  and  the  ventral  or  internal 
sides  so  near  one  another,  that  in  most  adults  the  light  will  shine  through 
them.  A  large  foramen  is  seen  on  the  venter  of  the  ilium,  and  another 
on  its  dorsum,  for  the  transmission  of  nutritious  arteries.  There  are 
several  others,  smaller,  at  various  points  of  the  os  innominatum,  for 
the  same  purpose,  and  for  the  adhesion  of  ligamentous  fibres. 


SECT.   V. — OF  THE  PELVIS  GENERALLY. 

The  sacrum  and  coccyx  behind,  and  the  ossa  innominata  at  the  sides 
and  in  front,  constitute,  as  observed,  the  whole  cavity  called  pelvis 
(bassin).  Its  position  is  such,  that,  in  the  adult,  it  divides  the  entire 
length  of  the  body  into  two  parts  nearly  equal,  the  head  and  trunk . 
forming  one  part,  and  the  lower  extremities  the  other.  Generally,  the 
former  are  somewhat  the  longer;  but  in  cases  of  unusual  corporeal 
stature,  the  excess  depends  upon  an  undue  length  of  the  inferior  ex- 
tremities. On  the  contrary,  in  persons  of  little  height,  the  latter  have 
not  been  developed  in  proportion  to  the  trunk  of  the  body. 

The  pelvis,  as  a  whole,  is  a  conoidal  cavity,  having  its  base  upwards, 
and  the  summit  below.  Its  internal  surface  forms  an  irregular  floor, 
on  which  the  viscera  of  the  abdomen  are  sustained  in  the  erect  posi- 
tion; and  its  external  surface,  by  projecting  considerably  at  various 
places,  establishes  very  favorable  points  for  the  attachment  of  mus- 
cles. 

The  internal  surface  of  the  pelvis  is  divided  by  the  projection  of  the 
anterior  margin  of  the  base  of  the  sacrum,  and  by  the  linea  ilio-pectinea, 
into  two  cavities;  the  upper  one  is  the  great  pelvis,  and  the  lower  one 
the  lesser  pelvis.  The  great  pelvis  is  the  base  of  the  cone,  and  presents 
at  its  anterior  part  a  large  deficiency,  which  is  supplied  in  the  fresh 
subject  by  the  abdominal  muscles.  The  lesser  pelvis  is  a  complete  bony 
canal,  much  deeper  behind  and  at  the  sides  than  in  front.  Its  depth, 
behind,  is  formed  by  the  whole  length  of  the  sacrum  and  coccyx;  at 
the  sides  by  the  bodies  of  the  ischia  and  a  small  part  of  the  ilia;  and, 
in  front,  only  by  the  length  of  the  bodies  of  the  pubes. 

The  upper  orifice  of  the  lesser  pelvis  is  called  the  superior  strait ;  it 
is  somewhat  oval,  and  looks  obliquely  forwards  and  upwards.  Its  axis 
may  be  indicated  by  a  line  drawn  from  the  extremity  of  the  coccyx  to 
a  point  an  inch,  or  thereabouts,  below  the  umbilicus.  The  inferior 
orifice  of  the  lesser  pelvis  is  called  the  inferior  strait.  Its  margins  in 
the  naked  skeleton  are  very  unequal,  for  it  presents  three  very  deep 
notches,  two  lateral,  and  one  in  front.  The  first  are  formed  by  the 
external  margins  of  the  sacrum  and  coccyx,  contributing  to  deepen  the 
sciatic  notch,  which  already  is  formed  in  each  innominatum.  The 
third  one  is  formed  by  the  convergence  of  the  rami  of  the  pubes  and 
ischia  of  the  opposite  sides,  and  constitutes  the  arch  of  the  pelvis  of 
authors,  sometimes  called  the  arch  of  the  pubes.  The  axis  of  the  lower 
strait,  it  is  clear,  must  have  a  very  different  direction  from  the  axis  of 
the  superior,  and  is  indicated  by  a  line  drawn  from  the  lower  part  of 


THE  PELVIS.  129 

the  first  bone  of  the  sacrum,  through  the  centre  of  this  opening.  The 
cavity  of  the  lesser  pelvis  is  increased  considerably  behind,  by  the  cur- 
vature of  the  sacrum ;  this,  however,  is  not  uniform,  as  the  sacrum  is 
much  more  curved,  as  well  as  longer  in  some  individuals  than  in  others. 
The  planes  of  the  ischia  are  not  parallel  with  one  another,  but  converge 
slightly  from  above,  in  consequence  of  which  the  transverse  diameter 
of  the  lower  strait  is  rather  smaller  than  the  transverse  diameter 
of  the  superior  strait. 

Difference  of  the  Pelvis  in  the  Male  and  the  Female. 

There  are  several  well-marked  peculiarities,  in  the  fully  developed 
pelvis  of  either  sex. 

The  ossa  ilia  are  larger,  less  concave,  and  more  horizontal  in  the 
female.  The  superior  strait  is  also  larger,  and  more  round:  its  trans- 
verse diameter  always  exceeds  the  antero-posterior;  whereas  of  the  two, 
the  latter,  in  the  male,  is  generally  found  the  longer.  The  lesser  pelvis 
is  also  more  capacious  in  women.  The  crura  of  the  pubes  and  ischia 
are  not  so  long  as  in  men;  but  they  diverge  more,  and  join  at  the  under 
part  of  the  symphysis  pubis  by  a  large,  regularly  rounded  arch ;  whereas, 
in  men,  the  arch,  as  it  is  called,  is  merely  an  acute  angle. 

The  os  sacrum  in  women  is  shorter,  more  concave;  and  is  also  broader 
in  proportion  to  its  length.  The  spaces,  vertically,  between  its  fora- 
mina in  front  are  very  small,  forming  ridges,  which  give  to  the  bone  the 
appearance  of  having  been  compressed  in  its  length. 

The  distance  between  the  upper  and  lower  straits,  or,  in  other  words, 
the  depth  of  the  small  pelvis  in  women,  is  not  so  gre#t  as  in  men :  this 
arises  from  the  comparative  shortness  in  the  length  of  the  pubes,  of 
the  ischia,  and  of  the  sacrum,  as  just  mentioned.  The  cartilaginous 
joining  of  the  pubes  is  thicker  in  women.  The  diameters  of  the  infe- 
rior strait,  like  those  of  the  superior,  are  longer  in  females. 

Accoucheurs  have  attached  much  importance  to  the  direction  and 
length  of  the  diameters  of  the  small  pelvis  in  well-formed  women. 
At  an  average  they  are  as  follows.  The  superior  strait  presents  three 
.diameters:  the  first  or  antero-posterior  extends  from  the  upper  ex- 
tremity of  the  symphysis  pubis  to  the  middle  of  the  projection  of  the 
sacrum  at  its  superior  margin,  and  measures  four  inches :  the  second 
diameter,  or  the  transverse,  crosses  the  first  at  right  angles,  and  extends 
from  the  middle  of  one  side  of  the  strait  to  the  corresponding  point 
on  the  other;  it  measures  five  inches:  the  oblique  diameter  extends 
from  the  sacro-iliac  junction  of  one  side  to  the  linea  ilio-pectinea  behind 
the  acetabulum  of  the  other,  and  measures  four  inches  and  a-half,  some- 
times more.1 

At  the  inferior  strait,  the  antero-posterior  diameter  is  from  the  lower 
part  of  the  symphysis  pubis  to  the  lower  end  of  the  sacrum,  and 
measures  five  inches.2  As  the  coccyx,  in  child-bearing  women,  is 
movable,  its  projection  forwards  is  not  taken  into  the  account,  because 
it  recedes  by  the  pressure  of  the  child's  head,  and  does  not  resist  its 

1  See  Dewees'  System  of  Midwifery,  7th  edition,  1S35,  p.  28. 

2  Dr.  Dewees  says  four.    Loc.  cit. 
VOL.  I. — 9 


130  SKELETON. 

Fig.  29. 


An  anterior  view  of  the  Female  Pelvis,  showing  the  shape  and  diameters  of  the  superior  strait. 
1,2.  The  antero-posterior  diameter,  measuring  4  inches.  3,4.  The  transverse  diameter,  measuring 
5  inches.  5,  5,  6,  6.  The  two  oblique  diameters,  measuring  4)£  inches  each. 

passage :  in  some  cases,  however,  it  is  unfortunately  fused  into  the 
sacrum,  and  therefore  perfectly  rigid,  which  will  diminish  this  diameter 
at  least  an  inch.  The  transverse  diameter  of  the  inferior  strait  is 
drawn  from  the  middle  of  the  internal  margin  of  the  tuberosity  of  one 
ischium  to  the  corresponding  point  on  the  other,  and  measures  four 
inches.  * 

The  depth  of  the  lesser  pelvis,  in  the  female,  at  the  symphysis 
pubis,  is  an  inch  and  a-half ;  at  the  posterior  part  four  inches,  or  five 
if  we  include  the  coccyx;  and  at  the  side  three  inches  and  a  half. 
There  are  many  other  details  connected  with  the  measurements  of  the 
pelvis,  which  are  mentioned  by  systematic  writers  on  midwifery. 


SECT.  VI. — DEVELOPMENT  OF  THE  PELVIS. 

Three  points  of  ossification  are  observable  in  the  os  innominatum  of 
the  early  foetus :  one  is  in  the  superior  portion  of  the  ilium ;  another  is 
in  the  tuberosity  of  the  ischium,  and  the  third  is  near  the  angle  of  the 
pubes.  The  radii  of  ossification  from  these  centres  have  extended 
themselves  considerably  at  birth,  so  as  to  sketch  out  the  forms  of  the 
bones  to^  which  they  respectively  belong.  But  these  bones  are  sepa- 
rated from  one  another  by  cartilage,  and  do  not  coalesce  till  years 
afterwards.  The  union  or  fusion  of  the  ilium  and  pubes  then  occurs 
at  the  ilio-pectineal  eminence,  over  the  acetabulum,  and  partly  in  this 
cavity:  the  ilium  and  ischium  join  in  the  acetabulum  principally,  and 
the  ischium  and  pubes  unite  by  their  respective  crura  at  the  middle 
of  the  internal  side  of  the  thyroid  foramen.  .  All  the  points  of  the  os 
innominatum,  most  remote  from  the  centres  of  its  three  pieces,  are  car- 
tilaginous at  birth:  as,  for  example,  the  crest,  the  spinous  processes, 


THE  PELVIS.  131 

the  tuberosity,  and  even  the  component  parts  of  the  acetabulum.  The 
latter  cavity  has  then  a  triangular  shape,  arid  from  its  very  flexible  and 
yielding  condition,  is  incapable  of  affording  a  strong  point  of  support 
to  the  trunk  in  the  erect  position. 

At  birth,  the  middle  parts  of  the  os  sacrum,  which  are  employed  in 
protecting  the  spinal  marrow,  are  more  advanced  in  their  ossification 
than  its  lateral  parts.  The  five  pieces  which  compose  it  are,  like  the 
bodies  of  the  true  vertebrae,-  of  a  rounded  shape.  The  processes  be- 
hind are  cartilaginous.  The  coccyx  is  extremely  small,  and  scarcely 
presents  any  ossification  whatever. 

The  pelvis  of  the  foetus,  at  birth,  is  smaller  in  proportion  than  the 
superior  portions  of  the  trunk ;  this  is  one  of  the  reasons  why  the 
abdomen  is  so  projecting.  The  lesser  pelvis  is  so  small  and  shallow 
that  the  bladder,  even  in  the  undistended  state,  cannot  be  accommo- 
dated by  it,  but  is  contained  principally  by  the  abdomen.  Its  trans- 
verse diameter  is  much  shorter  than  the  others.  The  superior  strait 
faces  much  more  forwards  than  in  the  adult. 


SECT.  VII. — ON  THE  MECHANISM  OF  THE  PELVIS. 
I 

The  pelvis  has  an  important  part  in  the  several  actions  of  standing  and 
of  locomotion ;  besides  its  usefulness  in  giving  a  support  to  the  viscera 
of  the  abdomen,  and  in  having  attached  to,  and  contained  within  it,  the 
organs  of  generation. 

In  standing,  the  pelvis  is  impelled  by  two  opposing  forces,  in  conse- 
quence of  the  attachment  of  the  vertebral  column  at  its  hind  part,  and 
of  the  ossa  femorum  at  its  anterior  lateral  parts.  The  weight  of  the 
head  and  of  the  upper  parts  of  the  body,  falling  upon  the  sacrum,  acts 
upon  a  lever,  which  is  represented  by  the  distance  between  the  aceta- 
bula  and  the  sacro-iliac  junction,  and  has  a  tendency  to  depress  the 
posterior  part  of  the  pelvis,  by  rotating  it,  upon  the  heads  of  the  thigh 
bones.  This  movement  is  obviated  by  the  iliacus  internus,  psoas 
magnus,  and  some  other  muscles,  which  keep  the  front  of  the  pelvis 
from  rising  up.  It  is  also  prevented  by  the  principal  weight  of  the 
trunk  being  in  front  of  the  spine,  and  therefore  inclining  forwards,  so 
that  the  centre  of  gravity,  in  the  erect  position,  gives  a  continual 
tendency  to  fall  forwards  instead  of  backwards. 

The  wedge-like  shape  of  the  sacrum  is  highly  favorable  to  the  erect 
position  :  from  having  its  base  upwards,  whenever  the  weight  of  the 
trunk  is  thrown  upon  it,  it  is  driven  down  between  the  ossa  innominata, 
and  has  the  tightness  of  its  articular  connection,  therefore,  much  in- 
creased by  the  position  which  it  is  intended  to  sustain.  In  illustration 
of  the  usefulness  of  the  triangular  or  wedge-like  shape  of  the  sacrum, 
it  may  be  observed,  that  it  is  much  less  so  in  animals  which  are  in- 
tended to  go  upon  all  fours  than  in  the  human  subject. 

The  articulation  of  the  several  bones  of  the  pelvis  with  each  other 
is  so  close  as  not  to  admit  of  any  motion  between  them,  with  the  ex- 
ception of  the  os  coccygis,  and  of  the  relaxation  peculiar  to  pregnancy. 
The  pelvis,  however,  has  upon  the  spine,  flexion,  extension,  lateral  in- 
clination, and  rotation  ;  the  latter  being  performed  by  a  series  of  very 


132  SKELETON. 

slight  twists  of  the  lumbar  vertebrae  upon  each  other.  Like  all  other 
motions,  it  is  much  extended  by  habit  in  early  life.  Of  this  I  have 
seen  an  instance,  in  an  adult  Indian,  who,  from  infancy,  had  been  de- 
prived entirely  of  the  use  of  the  lower  extremities ;  but  who,  by  being 
seated  in  a  large  wooden  bowl,  with  a  round  bottom,  and  having  his 
legs  drawn  up  in  a  squatting  position,  could,  by  alternate  twists  of 
the  spine,  with  the  assistance  of  a  short  staff  in  each  hand,  move  with 
surprising  speed  over  a  plane  surface.  -  • 


SECT.  VIII. — OF  THE  THORAX. 

The  thorax  is  the  upper  part  of  the  trunk,  and  is  formed  by  the 
dorsal  vertebrae  behind,  by  the  sternum  in  front,  and  by  the  ribs  with 
their  cartilages  at  the  intermediate  spaces.  In  its  periphery  it  is  of  a 
conoidal  figure,  flattened  in  front,  somewhat  bowed  behind,  and  semi- 
cylindrical  on  the  sides.  It  is  affected  in  its  shape  behind,  from  its 
symmetrical  division  into  two  parts  by  the  ridge  of  spinous  processes 
of  the  dorsal  vertebras.  On  each  side  of  this  ridge  is  a  depression 
called  the  vertebral  gutter,  formed  by  the  bridges  of  the  vertebrae,  their 
transverse  processes,  and  by  the  ribs  as  far  as  their  angles.  This 
gutter,  being  narrow  at  the  top,  augments  both  in  depth  and  breadth 
as  it  descends  to  the  last  rib;  the  increase  of  breadth  being  due  to 
the  successively  increasing  distance  of  the  angles  of  the  ribs  from  their 
heads.  The  interior  circumference  corresponds  with  the  exterior,  with 
the  exception  of  the  posterior  part,  where,  owing  to  the  projection  of 
the  column  of  dorsal  vertebrae,  a  partial  septum  exists  which  has  a 
tendency  to  divide  it  into  two  chambers.  The  superior  part  of  the 
cone,  or  its  summit,  is  much  smaller  than  the  inferior  part  or  the  base, 
and  presents  a  very  oblique  cordiform  foramen,  much  lower  in  front 
than  behind,  owing  to  the  superior  margin  of  the  sternum  being  lower 
than  the  first  dorsal  vertebra.  The  base  of  the  thorax  is  a  very  large 
opening :  its  lateral  and  posterior  margins,  formed  by  the  ribs  and  their 
cartilages,  present  a  convexity  downwards ;  but,  in  front,  where  the 
latter  run  up  to  join  the  sternum,  a  large  notch  is  formed  between  the 
cartilages  of  the  opposite  sides,  into  the  apex  of  which  notch  the  third 
bone  of  the  sternum  projects. 

Of  the  Ribs. 

The  ribs  (costse,  cdtes)  are  twenty-four  in  number,  twelve  on  each 
side.  Of  the  latter,  the  upper  seven,  in  consequence  of  their  cartilages 
joining  the  sternum,  are  called  the  sternal  or  true  ribs,  and  the  lower 
five,  from  their  cartilages  stopping  short  of  the  sternum,  are  called  the 
false  or  a-sternal  ribs.  Cases  are  recorded  by  several  anatomists  of 
there  being  eleven  or  thirteen  ribs  on  a  side :  the  latter  I  have  seen 
several  times,  and  the  former  but  once  or  twice.  In  such  cases,  the 
dorsal  vertebrae  correspond  in  number  with  the  ribs.  In  the  instances 
of  redundance  which  have  come  under  my  notice,  the  last  rib  looked 
like  a  transverse  process  of  unusual  length,  belonging  to  a  lumbar  ver- 
tebra. The  superabundant  vertebra  constituted  the  thirteenth  dorsal ; 


THE  THORAX.  133 

but  was  formed  like  the  first  lumbar  as  it  commonly  exists,  and  the  last 
lumbar  vertebra  was  anomalous  in  its  shape,  being  intermediate  in  form 
to  a  lumbar  vertebra,  and  to  the  first  bone  of  the  sacrum.1 

All  of  the  ribs  are  so  placed,  that  they  run  very  obliquely  downwards 
and  forwards  from  their  posterior  extremities.     This  obliquity  becomes 

Fig.  30. 


A  front  view  of  the  Thorax.  1 .  First  bone  of  the  sternum .  2.  Second  bone  of  the  sternum.  3.  Third 
bone  or  ensiform  cartilage.  4.  First  dorsal  vertebra.  5.  Last  or  twelfth  dorsal  vertebra.  6.  First 
rib.  7.  Its  head.  8.  Its  neck.  9.  Its  tubercle.  10.  Seventh  or  last  true  rib.  11,  11.  Costal  carti- 
lages. 12.  Floating  ribs.  13.  Groove  for  the  intercostal  artery. 

the  more  striking  as  the  ribs  increase  successively  in  length.  The  first 
rib,  for  example,  articulating  by  its  posterior  extremity  with  the  first 
dorsal  vertebra,  has  its  anterior  extremity  nearly  on  a  horizontal  line 
with  the  lower  part  of  the  third  dorsal  vertebra.  The  seventh  rib  has 
its  anterior  extremity  on  a  horizontal  line  with  the  lower  margin  of  the 
last  dorsal  vertebra,  notwithstanding  its  posterior  extremity  articulates 
with  the  seventh  dorsal  vertebra.  The  same  sort  of  comparison  may 
be  usefully  instituted  in  regard  to  all  the  ribs,  in  which  case  the  rule 
will  be  found  closely  applicable,  with  the  slight  exception  of  the  two 
or  three  last  ribs.  The  ribs  are  nearly  parallel  to  each  other  in  this 
obliquity,  allowance  being  made  for  the  effect  which  the  obliquity  of  the 
sternum  has  in  causing  a  greater  separation  of  their  anterior  extremi- 
ties from  each  other  than  exists  at  their  posterior  extremities. 

Common  points  of  resemblance  between  the  Ribs. — Each  rib  is  para- 
boloid ;  presents  an  external  and  an  internal  surface  ;  an  upper  and 
a  lower  margin ;  a  sternal  and  a  vertebral  extremity. 

The  external  surface  of  each  rib  is  convex,  while  its  internal  surface 
is  concave.  The  former  presents,  not  far  from  the  vertebral  extremity, 

1  The  thirteenth  rib  is  sometimes  an  appurtenance  to  the  last  cervical  vertebra,  of  which 
I  have  a  specimen,  kindly  presented  by  a  member  of  the  class  in  1848-49,  Dr.  Walter  F 
Atlee. 


134  SKELETON. 

an  oblique  ridge,  occasioned  by  the  insertion  of  the  sacro-lumbalis 
muscle.  It  is  precisely  at  this  line  that  a  curvature  takes  place,  which 
is  the  angle  of  the  rib.  Between  the  angle  and  the  transverse  process 
of  the  vertebra,  each  rib  is  rather  more  narrow  and  cylindroid  than  it 
is  in  advance  of  the  angle.  The  superior  margin  of  the  rib  is  rounded 
and  somewhat  rough,  for  the  insertion  of  the  intercostal  muscles,  while 
the  inferior  margin  is  brought  to  a  thin  cutting  edge.  Just  within, 
and  above  the  latter,  is  a  fossa  beginning  nearer  to  the  spine  than  the 
angle  of  the  rib,  and  ceasing  about  one-third  of  the  whole  length  of 
the  rib,  short  of  its  anterior  extremity.  It  contains  the  intercostal 
vessels  and  nerve.  From  the  upper  margin  of  this  fossa  arises  the  in- 
ternal intercostal  muscle,  and  from  the  lower  the  external. 

The  anterior  extremities  of  the  ribs  are  thin  and  flattened ;  in  the 
upper  eight  there  is  some  increase  in  their  breadth  at  this  point,  and 
in  all  there  is  an  oblong  pit  for  receiving  the  end  of  the  corresponding 
cartilage.  The  vertebral  extremity  of  the  rib  is  its  head,  and  presents 
two  flat  articular  surfaces,  separated  by  a  ridge.  This  head  is  received 
into  the  inter-vertebral  matter,  and  upon  the  articular  faces  of  the 
adjoining  margins  of  two  vertebrae.  A  small  depression  exists  upon 
the  posterior  face  of  the  rib  bordering  on  its  head,  for  containing  a  lit- 
tle fatty  mass.  About  an  inch  beyond  the  head,  at  the  posterior  under 
surface  of  the  rib,  is  a  tubercle,  presenting  a  smooth  articular  face,  for 
connecting  itself  with  the  transverse  process  of  the  vertebra  below. 
Just  beyond  this,  but  bordering  on  it,  is  a  much  smaller  tubercle,  not 
unfrequently  indistinct,  for  the  insertion  of  the  external  transverse 
ligament,  and  below  it  is  a  small  pit  for  the  lodgment  also  of  fatty 
matter  near  the  joint.  The  space  between  the  first  or  greater  tubercle 
and  the  head  of  the  rib  is  its  neck,  which  is  in  contact  with  the  antero- 
superior  face  of  the  transverse  process  of  the  vertebra  below,  and  has 
a  sharp  ridge  on  its  upper  margin,  for  the  insertion  of  the  internal 
transverse  ligament. 

The  most  of  the  ribs  have  a  very  sensible  twist  in  them,  by  which 
their  spinal  extremity  is  directed  upwards,  and  the  sternal  extremity 
downwards ;  from  which  it  results  that  the  whole  length  of  the  rib  can- 
not be  brought  into  contact  with  a  horizontal  plane. 

Differences  of  Ribs. — Though  there  are  many  common  points  of 
resemblance  among  the  ribs,  yet  there  are,  also,  some  well-marked 
peculiarities.  Thus  the  ribs  increase  successively  in  length  from  the 
first  to  the  seventh  inclusively ;  they  then  decrease  by  the  same  rule : 
the  last  is  not  only  the  smallest,  but  not  unfrequently  the  shortest.  The 
angles  of  the  ribs  increase  in  their  distance  from  the  spine,  from  the 
first  to  the  last  rib.  The  angle,  however,  of  the  first  rib  is  not  well 
marked,  from  its  being  so  near  the  tubercle ;  nor  is  the  angle  of  the 
last,  from  its  being  so  near  the  anterior  extremity.  The  oblique  ridges 
constituting  or  marking  off  the  angles  are  placed  one  above  the  other, 
in  the  same  line.  This  gives  to  the  back  of  the  thorax  a  triangular 
flatness,  the  base  of  which  is  below.  The  projection  backwards  of  the 
angles  of  the  ribs,  along  with  that  of  the  spinous  processes  of  the 
vertebrae,  forms  on  each  side  of  the  latter  the  vertebral  gutter,  which 


THE  THORAX.  135 

is  filled  up  by  the  large  muscles  that  keep  the  trunk  erect.     This  gutter 
is,  of  course,  broader  below. 

The  first  rib  is  more  circular  than  the  others.  Its  head  is  hemi- 
spherical, instead  of  presenting  two  articular  surfaces.  This  rib  is 
flat  above  and  below  ;  its  margins  are  internal  and  external.  It  has 
no  groove  for  the  intercostal  vessels  and  nerve.  About  the  middle,  the 
upper  surface  is  marked  by  a  superficial  oblique  fossa,  made  by  the 
subclavian  artery;  in  front  of,  and  behind  which  is  a  small  rising, 
marking  the  insertion  of  the  scaleni  muscles.  The  second  rib  is  con- 
Fig.  31. 


A  view  of  the  upper  side  of  the  first  Rib  of  the  right  side,  half  the  size  of  nature.  1.  The  head.  2. 
The  tubercle.  3.  Anterior  surface.  4.  Groove  for  the  subclavian  artery.  5.  Groove  for  the  subcla- 
vian vein.  6.  Anterior  extremity  for  the  cartilage.  7.  Tubercle  for  the  scalenus  anticus  muscle. 

siderably  longer  than  the  first,  and  has  its  flat  surfaces  obliquely 
upwards  and  downwards,  so  as  to  round  off  that  part  of  the  thorax. 
The  four  inferior  ribs  decrease  at  their  anterior  extremities,  or  become 
somewhat  tapering.  The  last  two  ribs  do  not  articulate  with  the  trans- 
verse processes,  and  consequently,  have  no  corresponding  tubercles. 
As  their  heads  articulate  with  the  middle  of  the  bodies  of  their  respect- 
ive vertebrae,  instead  of  with  the  margins,  they  present  only  a  single 
and  somewhat  convex  surface.  The  eleventh  rib  is  marked  only  for  a 
short  distance  in  its  middle  by  the  fossa,  for  the  intercostal  vessels. 
The  twelfth  rib  has  no  mark  of  the  kind. 

There  is  an  augmentation  in  volume  from  the  second  to  the  eighth 
rib,  inclusively ;  afterwards  they  decrease.  The  angles  of  the  ribs  are 
successively  more  and  more  obtuse. 

The  structure  of  the  rib  is  spongy,  covered  with  a  lamella  of  com- 
pact bone.  The  spongy  structure  predominates  at  the  anterior  ex- 
tremity, for  there  the  rib  is  comparatively  soft. 

Of  the  Sternum. 

This  bone  constitutes  the  middle  front  part  of  the  thorax,  and,  owing 
to  the  obliquity  of  the  ribs,  has  its  superior  end  on  a  horizontal  line 
with  the  third  dorsal,  while  its  inferior  extremity  is  on  a  horizontal 
line  with  the  eleventh  dorsal  vertebra.  It  is  also  placed  in  a  slanting 
direction,  so  that  the  lower  part  recedes  from  the  spine  much  farther 
than  the  upper. 

The  sternum  is  oblong,  somewhat  curved,  like  a  bow,  so  as  to  be 
convex  in  front,  and  concave  behind.  It  is  divided,  in  the  adult,  into 
three  distinct  pieces;  an  upper,  middle,  and  lower,  which  are  held 


136 


SKELETON. 


together  by  cartilage  and  by  ligament ;  but  not  unfrequently  in 
advanced  life  these  pieces  are  all  joined  into  one  by  bony  union.  The 
first  and  middle  parts  join  where  the  second  rib  is  articulated,  and  the 
middle  and  lower  where  the  seventh  rib  articulates.  At  these  points 
there  is  a  well-marked  transverse  ridge,  both  anteriorly  and  posteriorly, 
and  between  them,  on  the  front  of  the  bone,  there  are  other  ridges  not 
so  strong  indicating  the  original  separation  of  the  bone  into  several 
other  distinct  pieces.  These  ridges  are  of  a  more  condensed  bony 
matter  and  like  the  epiphyses  of  the  vertebrae.  The  lateral  margins  of 
the  sternum  are  somewhat  elevated  where  the  ribs  articulate. 

The  upper  end  of  the  sternum  is  both  thicker  and  broader  than  the 
lower  end.  Where  the  first  and  second  parts  join,  there  is  a  narrowing 
of  the  two :  the  same  occurs  where  the  second  and  third  pieces  unite. 

The  first  or  upper  bone  of  the  sternum  has  an  irregular  square 
figure ;  it  projects  somewhat  above,  and  is  slightly  hollow  below.  It  is 
scooped  out  at  the  superior  margin,  and  presents  a  point  at  each  end  of 
the  scoop.1  At  the  side  of  the  latter  is  a  concave  and  rounded  surface, 
for  articulating  with  the  clavicle ;  just  below  which  is  a  rough  surface, 
for  the  cartilage  of  the  first  rib.  The  bone  diminishes  much  in  breadth 
from  this  point,  and  terminates  by  a  narrow  oblong  face,  joining  it  to 
the  second  piece.  At  each  side  of  this  junction  both  pieces  contribute 
to  a  fossa  for  the  cartilage  of  the  second  rib. 

The  second  bone  of  the  sternum  is  longer  and  narrower  than  the  first. 
At  its  lower  part  it  increases  somewhat  in  breadth,  and  then  terminates 
by  being  rounded  off  on  either  side,  so  that  its  margins  converge  to- 
wards each  other.  The  sides  of  this  piece  afford 
complete  pits  for  the  third,  fourth,  fifth,  and 
sixth  ribs  ;  the  pit  for  the  seventh  is  common  to 
it  and  the  third  bone,  as  the  pit  for  the  second 
rib  is  common  to  it  and  the  first  bone.  The 
sixth  and  seventh  pits  are  in  contact,  the  fifth  is 
very  near  the  sixth,  the  fourth  is  about  half  an 
inch  above  the  fifth.  On  viewing  the  whole  side 
of  the  sternum,  it  will  be  observed  that  the  dis- 
tances between  the  pits  decrease,  successively, 
from  the  first  to  the  last. 

The  third  bone  of  the  sternum,  in  the  young 
adult,  is  frequently  in  a  great  degree  or  wholly 
cartilaginous;  hence  the  name  of  xyphoid  carti- 
lage (cartilago  xyphoides  or  ensiformis)  has  been 
applied  to  it.  It  is  thin,  varies  remarkably  in 
its  breadth  in  different  individuals,  and  has  the 
lower  extremity  sometimes  turned  forwards  and 
sometimes  backwards,  but  most  frequently  it  is 
inclined  only  slightly  forwards.  The  base  of 
this  piece  presents  a  narrow  oblong  surface  for 
articulating  with  the  second  bone,  at  each  end 


Fig.  32, 


A  front  view  of  the  Ster- 
num. 1.  First  piece.  2.  Se- 
cond piece.  3.  Ensiform  car- 
tilage, or  third  piece.  4.  Ar- 
ticular face  for  the  clavicle. 
5.  Articular  face  for  the  first 
rib.  6.  Articular  face  for 
the  second  rib.  7,  8,  9,  10. 
Articular  faces  for  the  last 
five  true  ribs. 


1  At  this  point  in  persons  somewhat  advanced  in  life  there  sometimes  exist  distinct  ossi- 
fications, one  on  each  side ;  they  are  described  as  Epi-sternal  bones,  or  granules,  by  Mr. 
Breschet. 


CARTILAGES  OF  THE  RIBS.  137 

of  which  is  the  half  fossa  for  the  seventh  rib.  The  margins  of  the 
ensiform  cartilage  are  thin,  and  have  the  transverse  muscles  of  the 
abdomen  inserted  into  them.  Sometimes  the  lower  extremity,  instead 
of  being  pointed,  is  bifurcated. 

The  sternum  is  composed  of  a  spongy  texture,  enveloped  by  a  thin 
layer  of  compact  substance.  Its  strength  depends,  in  a  great  degree, 
upon  its  ligamentous  covering. 


SECT.  IX. — OF  THE  CARTILAGES  OF  THE  RIBS. 

These  are  placed  at  the  anterior  extremities  of  all  the  ribs,  the  seven 
superior  of  which  they  unite  to  the  sternum  by  filling  up  the  space. 
The  length,  breadth,  and  direction  of  these  cartilages  are  far  from  be- 
ing uniform. 

The  first  costal  cartilage  is  short ;  the  following  ones  increase  in 
length,  successively,  to  the  seventh  inclusively.  The  cartilages  of  the 
false  or  abdominal  ribs  decrease,  successively,  in  length  from  the  eighth 
to  the  twelfth,  inclusively ;  the  last  is  a  mere  tip  to  the  end  of  the  rib. 
The  breadth  of  the  first  cartilage  is  considerable  near  the  sternum; 
the  succeeding  ones  are  not  so  large  at  this  point.  With  the  exception 
of  the  first  three,  the  costal  extremities  of  the  cartilages  are  larger 
than  the  sternal ;  and  they  become  more  rounded  as  they  advance  to 
the  latter.  The  cartilages,  in  point  of  magnitude,  generally,  will  be 
found  in  proportion  to  the  size  of  the  ribs  with  which  they  articulate. 
The  sixth  and  seventh,  at  their  middle,  are  held  together  by  ligament 
and  spread  out,  which  gives  there  an  increase  of  breadth,  and  permits 
them  to  touch,  and  sometimes  to  coalesce. 

The  first  cartilage  goes  obliquely  downwards  in  the  direction  of  the 
rib  to  which  it  belongs,  in  order  to  join  the  sternum.  The  second  and 
the  third  cartilages  are  nearly  horizontal,  but  inclining  a  little  upwards 
in  their  progress ;  the  fourth,  fifth,  sixth,  and  seventh  pass  success- 
ively, more  and  more  upwards  to  the  sternum,  in  consequence  of  the 
increasing  length  of  the  ribs  requiring  them  to  traverse  a  longer  space 
to  reach  this  bone.  From  the  direction  of  the  cartilages  being  ob- 
liquely upwards,  while  that  of  the  ribs  is  obliquely  downwards,  the 
angle  formed  near  the  rib  at  the  base  of  the  cartilage,  where  the  lat- 
ter begins  first  to  turn  upwards,  is  less  obtuse  in  the  lower  cartilages 
than  in  the  upper.  The  obliquity  of  these  cartilages  is  also  very 
manifest,  by  comparing  them  with  the  side  of  the  sternum  :  with  it  they 
form  a  very  acute  angle  below,  and  a  very  obtuse  one  above. 

The  cartilages  of  the  false  ribs,  as  they  decrease  successively  in 
length,  terminate  in  front  by  small  tapering  extremities.  The  first  is 
united  by  ligaments,  somewhat  closely,  to  the  last  true  or  sternal,  and 
is  occasionally  sent  forward  fully  to  the  sternum.  The  others  are 
united  more  loosely,  in  such  a  way  that  the  anterior  extremity  of  the 
one  below  lies  against  the  inferior  margin  of  that  which  is  above.  The 
eleventh  and  twelfth  cartilages  are  generally  each  too  short  to  touch 
the  one  above  it ;  they  therefore  are  fixed  principally  by  a  connection 


138  SKELETON. 

with  the  abdominal  muscles.     Their  ribs  are  much  more  movable  than 
any  others,  and  have  been  called  floating,  from  that  cause. 

There  is  some  difference  between  the  two  extremities  of  the  carti- 
lages ;  the  posterior  or  costal  is  a  convex,  unequal  surface,  very  closely 
united  to  the  anterior  extremity  of  the  corresponding  rib.  The  other 
or  sternal  extremity  in  the  sternal  cartilages  offers  a  smooth  articular 
face,  which  is  angular  or  convex,  according  to  the  shape  of  the  cavity 
in  the  sternum  with  which  it  has  to  articulate.  The  first  three  ab-sternal 
and  the  last  sternal  cartilage  make,  to  the  lower  part  of  the  thorax,  a 
broad  and  well-marked  margin,  convex  in  front  and  concave  behind. 

The  cartilages  of  the  ribs  are,  in  persons  of  middle  age,  white,  flexi- 
ble, and  very  elastic.  They  are  dissolved  very  slowly  in  boiling  water ; 
by  which  they  are  reduced  to  gelatin,  if  young;  otherwise  their  solu- 
bility is  very  imperfect.  They  have  a  structure  differing,  in  some  re- 
spects, from  other  cartilages;  when  dried,  and  exposed  to  the  action  of 
the  atmosphere,  they  are  seen  to  consist  of  an  immense  number  of  small 
thin  plates,  placed  face  to  face,  and  separated  by  deep  fissures.  M. 
Herissant  describes  these  plates  as  interlaced  one  with  another,  and 
forming  a  kind  of  spiral,  the  regularity  of  which  is  interrupted  by  small 
cartilaginous  projections,  uniting  the  plates  to  each  other.1  These  car- 
tilages have  a  great  disposition  to  ossify,  which  is  manifested  in  most 
individuals  somewhat  advanced  in  life.  The  ossification  begins  in  their 
centre,  and  advances  to  the  circumference,  and  is  always  preceded  by 
a  yellowish  tinge.  When  they  are  fully  ossified,  like  the  ribs,  they  are 
cellular  within,  and  compact  externally,  and  are  continuous  with  the 
ribs,  there  being  no  interval :  in  such  cases,  the  distinction  from  the 
sternum  is  generally  kept  up  by  the  preservation  of  the  joint,  with  the 
exception  of  the  first,  which  is  ossified  into  it.  The  complete  ossifica- 
tion of  the  first  cartilage  is  not  uncommon ;  the  others,  though  there  is 
generally  in  old  persons  a  considerable  deposit  of  bone  in  them,  are 
seldom  fully  ossified.  In  neither  case,  however,  is  it  common  to  see 
such  a  perfect  continuity  of  bone  between  the  rib  and  sternum,  that  the 
junction  may  not  be  dissolved  at  one  point  or  another  of  this  space  by 
the  action  of  boiling  water ;  at  least,  after  very  numerous  observations 
on  this  subject,  I  do  not  remember  to  have  met  with  a  single  instance 
of  it. 


SECT.  X. — OF  THE  DEVELOPMENT  OF  THE  THORAX. 

In  the  foetus  the  shape  of  the  thorax  differs  much  from  that  of  the 
adult,  in  the  greater  comparative  extent  of  its  antero-posterior  diameter, 
and  in  the  projection  of  the  sternum.  The  state  of  the  thoracic  viscera, 
at  this  period,  calls  for  such  an  arrangement ;  as  the  heart  and  thymus 
gland,  which  are  in  the  middle,  have  a  considerable  extent;  whereas, 
the  lungs  are  still  collapsed  from  the  emptiness  of  their  air  cells.  The 
ribs  are  but  little  curved  at  their  posterior  parts,  the  angle  being  by  no 
means  well  formed,  in  consequence  of  which,  the  fossa  on  each  side  of 
the  bodies  of  the  vertebrae,  wiftiin  the  thorax,  is  not  so  deep ;  neither 

1  Acad.  des  Sciences,  an.  1748. 


DEVELOPMENT  OF  THE  THORAX. 


139 


is  the  fossa  behind,  on  each  side  of  the  spinous  processes,  so  fully 
marked.  The  superior  opening  of  the  thorax  is  more  round  from  the 
increase  of  the  antero-posterior  diameter.  The  inferior  opening  is 
extremely  large,  both  from  the  elevation  of  the  sternum,  and  from  the 
pressure  of  the  abdominal  viscera,  of  which  the  liver,  from  its  great 
extent,  is  a  principal  agent.  The  vertical  diameter  of  the  thorax  is 
small,  from  the  ribs,  particularly  the  lower  ones,  being  pressed  up  one 
against  the  other,  by  the  diaphragm,  acted  on  by  the  abdominal  viscera. 

The  bones  individually  are  in  the  following  state  at  birth.  The  ribs 
are  almost  completed,  the  heads  where  they  join  the  spine  being  in  a 
state  nearly  as  perfect  as  at  any  subsequent  period  of  life,  and  not  by 
any  means  in  the  condition  of  a  cartilaginous  epiphysis,  as  is  presented 
in  the  extremities  of  the  cylindrical  bones  generally.  These  bones,  as 
Bichat  very  justly  observes,  are  destined  to  a  function  which  commences 
immediately  upon  birth,  and  which  requires  in  them  as  much  perfection 
then,  as  they  have  in  the  adult.  For  respiration  is  different  from  loco- 
motion ;  the  latter  requires  a  species  of  education,  which  may  be  given 
gradually,  whereas  one  respires  from  the  beginning  as  he  will  respire 
always.  The  sternum,  wnich  is  less  immediately  connected  with  breath- 
ing, and  only  contributes  to  the  general  solidity  of  the  thorax  by  com- 
pleting its  circumference,  is  in  a  state  almost  cartilaginous,  and  presents 
only  nuclei  of  ossification  in  its  several  pieces. 

At  the  instant  of  birth,  a  great  change  is  produced  in  the  dimensions 
of  the  thorax.  The  lungs,  from  being  in  a  collapsed  and  solid  state, 
suddenly  suffer  an  expansion  of  their  cells  by  the  introduction  of  air 
into  them,  and  increase  twice  or  three  times  in  magnitude.  This  is 
accomplished  by  the  elevation  of  the  ribs,  and  the  consequent  increase 
in  the  transverse  diameter  of  the  thorax  :  it  becomes  a  condition  that 
for  ever  afterwards  remains,  so  that  the  lungs,  even  upon  death,  con- 
tinue to  have  their  air  cells  distended,  and  do  not  return  to  a  perfectly 
collapsed  state.  The  action  of  the  diaphragm  is  but  small  in  the 
earlier  periods  of  life ;  owing  to  the  size  and  pressure  of  the  abdominal 
viscera  against  it ;  respiration  is  then  principally  carried  on  by  the 
elevation  and  depression  of  the  ribs,  and  by  their  being  rolled  outwards, 
a  motion  which  the  flexibility  of  their  cartilages  and  the  looseness  of 
their  articulating  surfaces  favor  very  much. 

At  the  age  of  puberty,  the  thorax  experiences  a  remarkable  augmen- 
tation. Its  transverse  diameter  is  sensibly  increased,  and  there  is  a 
general  expansion  of  its  volume,  indicative  of  a  healthy  and  vigorous 
constitution.  Should  this  not  take  place,  and  the  sternum  be  pro- 
jected, it  is  supposed  to  mark  a  disposition  to  consumption.  The 
enlargement  of  the  thorax  is  undoubtedly  also  connected  with  a  deve- 
lopment of  the  organs  of  generation  at  the  same  time.  The  exercise 
of  the  latter  requires  greater  vital  powers  than  exist  in  early  life,  and 
the  provision  for  it  is  manifested  by  the  general  increase  of  vigor  and 
firmness  in  the  human  frame  ;  but  it  is  not  possible  to  point  out  in 
what  manner  the  sympathy  exists,  which,  on  the  development  of  the 
organs  of  generation,  extends  their  influence  to  the  bony  structure  of 
the  thorax. 


140  SKELETON. 


SECT.  XI. — OF  THE  MECHANISM  OF  THE  THORAX. 

The  thorax  performs  two  very  important  offices  in  the  animal  ma- 
chine ;  the  first  is  to  contain  and  protect  the  organs  of  circulation  and 
of  respiration,  the  second  to  assist  in  the  function  of  respiration  and 
perhaps  that  of  circulation.1 

The  mechanism  of  the  thorax  is  such  that  the  solidity  of  its  materials, 
and  its  rounded  shape,  present  a  very  efficacious  defence  of  its  viscera, 
from  the  influence  of  blows  on  its  outside.  The  effects  of  the  latter 
are  also  materially  diminished  by  the  thickness  and  contraction  of  the 
several  larger  muscles  which  are  placed  on  its  surface.  On  its  back 
part  the  thick  longitudinal  muscles  of  the  spine,  as  well  as  those  run- 
ning to  the  superior  extremities,  fill  up  the  gutters  on  each  side  of  the 
spinous  processes,  and  make  a  fleshy  protuberance,  divided  into  two  by 
the  raphe  which  extends  the  length  of  the  back  over  the  spinous  pro- 
cesses. In  front  it  is  less  protected,  owing  to  the  sternum  being  im- 
mediately under  the  skin.  Nevertheless,  when  blows  are  inflicted  on 
this  part,  their  effects  are  much  diminished  by  the  elasticity  of  the 
cartilages  of  the  ribs,  and  by  the  direction,  obliquely  downwards,  of 
the  ribs  themselves ;  both  of  which  dispose  the  sternum  to  retreat 
backwards,  and  to  yield  to  the  impelling  force.  The  recession  will 
take  place  more  readily  at  the  moment  of  expiration,  and  when  the 
muscles  which  elevate  the  ribs  are  not  on  their  guard.  In  those  delibe- 
rate exertions  of  the  strength  of  the  thorax,  exhibited  by  individuals 
lying  down  on  their  backs,  and  sustaining  a  heavy  weight  on  the  ster- 
num, the  ribs  are  saved  from  injury  by  different  means.  The  arched 
form,  itself,  of  the  front  of  the  thorax,  is  of  considerable  service  in  the 
resistance  under  such  circumstances ;  this,  however,  would  be  easily 
overcome,  and  the  ribs  would  break,  if  the  arch  were  not  sustained  in  its 
elevation  by  the  contraction  of  the  large  muscles  on  its  sides,  as  the  ser- 
ratus  major,  the  pectoralis  major  and  minor,  each  of  which,  by  acting  on 
the  depressed  anterior  extremities  of  the  ribs  and  their  cartilages,  has  a 
tendency  to  keep  them  elevated.  Fractures  of  the  ribs,  from  blows  or 
force  applied  in  front,  are  not  so  liable  to  occur  in  the  part  stricken 
as  in  the  point  feeling  the  greatest  momentum,  which  from  the  semi- 
circular form  of  the  ribs  is  in  or  near  their  middle  :  this  exhibits  a 
true  example  of  what  the  French  writers  call  the  contre-coup.  Bichat 
says  that  the  fracture  by  contre-coup  is  much  more  common  when  the 
individual,  being  struck  unexpectedly,  has  not  had  time  to  throw  his 
muscles  into  a  state  of  contraction,  for  the  protection  of  the  ribs. 

The  lateral  convexity  of  the  thorax  being  greater  than  that  in  front 
or  behind,  and  having  the  same  assistance  from  the  muscles  mentioned, 
presents  a  stronger  resistance  when  blows  are  inflicted  directly  on  it. 
Each  rib  represents  an  arch,  the  summit  of  which  is  its  centre,  and 
the  base  its  two  extremities.  The  abutments  of  the  base  are,  the  ster- 
num at  one  end  and  the  spine  at  the  other  :  a  displacement  from  them 
is  completely  prevented  by  the  strength  of  the  ligamentous  attach- 

1  A  very  interesting  paper  on  this  subject  was  presented  to  the  French  Institute  by  M. 
Barry,  some  years  ago. 


MECHANISM  OF  THE  THORAX.  141 

ments,  as  well  as  by  the  form  of  the  surfaces.  Under  these  circum- 
stances, as  fracture  occurs  preferably  to  dislocation,  it  is  generally  at 
the  point  stricken. 

The  abdominal  or  false  ribs,  from  their  want  of  attachment  to  the 
Bternum,  present  a  very  different  condition.  Their  anterior  extremities, 
therefore,  yield  readily,  and  are  driven  inwards  towards  the  abdomen. 

The  second  function  of  the  thorax,  relating  to  its  influence  on  respira- 
tion, is  executed  by  its  dilating  and  contracting,  whereby  the  air  is 
received  into,  and  expelled  from  it.  The  spine  is  the  fixed  point  for 
the  motions  of  the  ribs  in  respiration.  In  the  act  of  dilatation,  the 
capacity  of  the  thorax  is  augmented  in  three  directions,  vertically, 
transversely,  and  antero-posteriorly,  or  from  the  sternum  to  the  spine. 
The  vertical  augmentation  is  accomplished  by  the  diaphragm  ;  and,  as 
mentioned,  is  much  greater  proportionally  in  the  adult  than  in  the 
infant,  from  the  greater  comparative  size  of  the  abdominal  viscera  in 
the  latter.  The  transverse  augmentation  is  produced  by  the  successive 
contraction  of  the  intercostal  muscles,  which  raise  the  ribs  upwards. 
The  first  rib  is  moved  inconsiderably,  in  consequence  of  its  shortness 
and  of  its  continuity  with  the  sternum.  The  attachment  of  the  scaleni 
muscles  to  its  upper  surface  serves  rather  to  give  a  fixation  to  it,  and 
to  prevent  it  from  being  drawn  down  by  the  other  ribs,  than  to  produce 
by  their  contraction  an  elevation  of  it.  The  first  rib  may,  therefore, 
be  considered  as  a  fixed  point.  The  first  intercostal  muscles  contract- 
ing from  it  draw  up  the  second  rib,  which,  in  its  turn,  becoming  a 
fixed  point  for  the  second  intercostal  muscles,  they  contract  and  draw 
up  the  third  rib,  and  so  on  successively  to  the  last.  It  is  the  obliquity 
of  the  ribs  from  behind,  downwards  and  forwards,  which  enables  this 
elevation  of  them  to  produce  an  increase  in  the  lateral  diameter  of  the 
thorax :  without  such  obliquity,  their  elevation  would  not  have  the 
effect.  But  the  obliquity  alone  could  be  of  but  little  service,  if  the 
anterior  extremities  of  the  ribs  were  not  attached  to  the  sternum  by 
cartilages,  which  have  to  ascend  in  order  to  reach  it ;  for  it  is  obvious 
that  the  angle  of  the  cartilage  and  rib,  during  their  elevation  by  the 
intercostal  muscles,  has  a  tendency  to  enlarge  itself;  and  will,  in  doing 
so,  increase  the  horizontal  distance  between  the  anterior  end  of  the  rib 
and  the  sternum,  and  consequently  increase  the  transverse  diameter  of 
the  thorax.  The  upper  ribs,  from  the  shortness  as  well  as  direction  of 
their  cartilages,  can  do  little  or  nothing  in  increasing  this  diameter. 

According  to  some  anatomists,  the  capacity  of  the  thorax  is  also 
augmented  by  a  rocking  motion  of  the  rib,  in  which  the  two  extremities 
being  stationary,  the  middle  is  drawn  upward  and  outward.  It  is  not, 
however,  very  clear  that  this  motion  exists  to  much  extent  in  the 
adult,  as  the  posterior  articulations  of  the  thorax  are  opposed  to  it. 

While  the  transverse  enlargement  of  the  thorax  is  going  on,  a  simul- 
taneous motion  occurs  in  the  sternum,  and  in  consequence  of  the  oblique 
direction  in  which  the  ribs  run  to  it,  the  sternum  is  caused,  by  the 
elevation  of  their  bodies,  to  recede  from  the  spine.  But,  as  the  ribs 
increase  successively  in  length  from  the  first  to  the  seventh,  each  lower 
one,  in  its  elevation  from  the  oblique  towards  the  horizontal  line,  has 
its  anterior  extremity  carried  proportionably  farther  off  from  the  spine  ; 
hence,  the  sternum  has  a  combined  movement  resulting  from  its  several 


142  SKELETON. 

attachments  to  the  ribs :  one  motion  elevates  it  as  a  whole,  another 
causes  it  to  recede  from  the  spine  as  a  whole  :  and  the  third  causes  its 
lower  end,  from  the  increased  length  of  the  ribs  there,  to  be  pushed 
farther  from  the  spine  than  the  upper ;  giving  it,  thereby,  during 
respiration,  a  slight  motion  backwards  and  forwards,  resembling  that  of 
a  pendulum.  This  latter  motion,  however,  though  its  existence  is  clear, 
is  not  very  considerable,  from  the  sternum  being  kept  in  check  by  the 
tendinous  centre  of  the  diaphragm,  as  one  may  prove  by  examining  his 
own  body.  The  enlargement  of  the  thorax,  in  its  antero-posterior 
diameter,  is  much  more  considerable  at  the  anterior  extremities  of  the 
ribs,  becaus'e  there,  they  are  comparatively  free.  In  this  case,  the 
cartilages  of  the  ribs  are  bent  forwards,  besides  being  elevated. 

In  expiration,  the  movements  of  the  thorax  are  exactly  the  reverse  of 
what  they  are  in  inspiration,  and  all  its  diameters  are,  consequently, 
diminished.  Whatever  may  be  said  of  muscular  influence  in  producing 
this  change,  it  is  much  exaggerated.  It  is  true,  that  there  are  certain 
muscles  which  may  be  applied  to  this  end,  as  the  abdominal,  and  also 
some  on  the  back,  as  the  longissimi  dorsi  and  sacro-lumbales  ;  but  that 
they  are  actually  so  engaged,  under  ordinary  circumstances,  is  rather 
questionable.  In  observing  the  phenomena  of  natural  respiration, 
when,  by  position,  all  these  muscles  are  put  into  a  state  of  relaxation, 
it  does  not  appear  that  the  process  is  at  all  impaired  by  their  being 
thrown  out  of  action.  The  only  muscles,  therefore,  that  seem  to  be 
especially  appropriated  to  produce  expiration,  are  few  and  small :  they 
are  the  serrati  inferiores  postici,  one  on  either  side  of  the  spine.  But, 
when  the  lower  ribs  are  fixed  by  the  several  muscles  inserted  into  them, 
they  become  points  of  support  to  the  upper  ones  ;  and  then  the  inter- 
costal muscles  may  officiate  in  expiration,  by  drawing  the  ribs  succes- 
sively downwards,  as  they  do  in  inspiration,  by  drawing  the  ribs 
successively  upwards. 

The  elasticity  of  the  cartilages,  by  which  these  bodies  are  enabled 
to  return  from  the  constrained  state  in  which  they  were  placed  by  in- 
spiration, has  also  been  supposed  important  to  expiration,  by  Haller, 
and  others.  The  power  thus  derived  is  certainly  of  some  value ;  but 
of  much  less  than  has  been  attached  to  it.  It  unquestionably  exists  in 
early  and  middle  life,  but  is  lost  in  old  age,  when  the  cartilages  ossify, 
and,  therefore,  are  of  diminished  elasticity.  The  true  and  efficient 
cause  of  expiration  appears  to  be  atmospheric  pressure,  upon  the  ex- 
ternal parietes  of  the  thorax,  acting  along  with  the  natural  elasticity 
of  the  lungs.  The  lungs,  it  is  well  known,  when  in  a  state  of  repose, 
and  removed  from  the  thorax,  are  much  smaller  than  the  cavities  which 
they  fill  during  life.  They  have,  therefore,  a  continual  disposition,  in 
the  living  state,  to  return  to  the  size  which  is  most  easy  to  them  ;  and, 
when  they  are  dilated  by  inspiration,  they  subsequently  contract. 
These  positions  are  proved  conclusively  by  the  condition  of  the  inferior 
surface  of  the  diaphragm  in  a  healthy  and  entire  thorax  ;  where  this 
muscle,  in  consequence  of  atmospheric  pressure  from  without,  is  driven 
high  up  into  its  cavity.  Its  contraction  in  inspiration  draws  it  down, 
and  the  instant  that  the  contraction  ceases,  it  is  impelled  upwards  again. 
Now,  the  same  power  is  applied  to  the  whole  periphery  of  the  thorax : 
and  its  cavity  being  enlarged  by  the  contraction  of  the  several  muscles 


THE  CRANIUM.  143 

appropriated  to  the  elevation  of  the  ribs,  the  moment  this  contraction 
ceases,  the  latter  are  impelled  downwards.  From  all  this  it  will  be 
understood  that  the  muscles,  by  creating  a  vacuum  in  the  lungs,  cause 
the  vacuum  to  be  filled  by  the  introduction  of  air  through  the  trachea  ; 
and  upon  their  ceasing  to  contract,  the  several  agents  mentioned  cause 
the  expulsion  of  the  same  air.  It  is  generally  believed,  that  the  surface 
of  the  lung  is  everywhere  in  contact  with  the  thorax ;  it  appears,  how 
ever,  doubtful,  whether  there  is  not  a  space  between  the  pleura  pulmo- 
nalis  and  diaphragmalis,  particularly  at  the  most  posterior  and  inferior 
part  of  the  diaphragm.  Certain  it  is  that  adhesions  there  are  much 
less  common  than  in  other  parts  of  the  thorax. 

The  ligaments  at  the  spinal  extremities  of  the  ribs,  by  being  put  on 
the  stretch  in  inspiration,  have  also  some  tendency  to  throw  down  the 
ribs  in  expiration.  In  short,  the  contraction  of  the  thorax  may  be  set 
down  as  the  result  of  the  joint  action  of  the  atmosphere,  the  cartilages 
of  the  ribs,  the  ligaments,  the  contraction  of  the  lungs,  and  the  muscles. 
When  the  structure  of  the  lung  is  so  altered  that  its  elasticity  is  im- 
paired or  destroyed,  expiration  becomes  then  much  more  difficult. 


CHAPTER  II. 
OF  THE  HEAD. 

THE  head  is  placed  upon  the  upper  extremity  of  the  vertebral  co- 
lumn, and  consists  in  a  considerable  number  of  bones,  which  are  either 
in  pairs,  or,  if  single,  have  the  two  sides  symmetrical.  Some  of  these 
bones  form  a  large  cavity,  the  cranium,  for  containing  the  brain ;  the 
others  are  employed  in  the  formation  of  the  nose ;  of  the  orbit  for  the 
eyeball ;  and  of  the  mouth.  The  head,  for  the  most  part  ovoidal,  pre- 
sents very  striking  varieties  of  form  between  different  individuals  and 
different  nations.  It  is  thought  by  physiologists  that  the  moral  or 
intellectual  condition  of  a  people,  their  habits,  climate,  and  food,  have 
a  powerful  influence  in  producing  these  diversities.  The  head  is  di- 
vided into  Cranium  and  Face. 


SECT.  I. — OF  THE  CRANIUM. 

The  Cranium  is  composed  of  eight  bones  :  The  Os  Frontis,  the  Os 
Occipitis,  two  Ossa  Parietalia,  two  Ossa  Temporum,  the  Os  Sphenoides, 
and  the  Os  Ethmoides.  The  Os  Frontis  is  at  the  front  of  the  Cra- 
nium ;  the  Os  Occipitis  is  at  its  hind  part ;  the  Ossa  Parietalia,  one  on 
each  side,  form  its  superior  lateral  parts ;  the  Ossa  Temporum,  also 
one  on  each  side,  form  its  inferior  lateral  parietes ;  the  Os  Sphenoides 
is  in  the  middle  of  its  bottom  part ;  and  the  Os  Ethmoides  is  at  the  fore 
part  of  the  centre  or  body  of  the  last  bone. 

The  cavity  thus  formed  for  the  brain  has  three  diameters,  which 
may  be  learned  by  sawing  vertically  through  the  middle  line  of  one 


144  SKELETON. 

skull,  and  horizontally  through  the  cavity  of  another.  The  first  dia- 
meter is  the  longest,  and  extends  from  the  lower  part  of  the  frontal  bone 
to  the  protuberance  on  the  middle  of  the  interior  surface  of  the  os  occi- 
pitis,  or  a  little  above  it ;  it  is  commonly  from  six  inches  and  a-half  to 
seven  long.  The  second  diameter  includes  the  space  between  the  supe- 
rior margins  of  the  temporal  bones,  where  they  are  most  distant  from 
each  other,  and,  passing  over  the  middle  of  the  great  occipital  foramen, 
is  from  five  inches  to  five  and  a-half.  The  third  diameter  is  taken  from 
the  centre  of  the  great  occipital  foramen  to  the  centre  of  the  suture  be- 
tween the  parietal  bones ;  it  is  also  from  five  inches  to  five  and  a-half. 
Rather  more  than  one-third  of  the  cavity  of  the  cranium  is  placed  be- 
hind the  second  diameter,  and  it  diminishes  somewhat  abruptly ;  but  in 
front  of  this  diameter  the  cavity  is  finished  more  gradually. 

When  the  face  is  separated  from  the  cranium,  the  exterior  surface  of 
the  latter,  excepting  its  base,  represents  somewhat  accurately  the  form 
and  proportion  of  its  cavity:  allowance  being  made  for  the  large  sinuses 
in  the  lower  part  of  the  frontal  bone,  and  for  the  thinness  of  the  upper 
parts  of  the  temporal  bones.  The  diameters  mentioned  can  only  repre- 
sent what  most  frequently  happens,  for  daily  observation  proves  remark- 
able departures  from  them.  Sometimes  the  transverse  diameter  is 
increased  at  the  expense  of  the  longest,  which  gives  to  the  cranium  a 
flatness  before  and  behind.  On  other  occasions,  the  vertical  diameter 
is  increased,  and  the  others  reduced,  whereby  the  cranium  receives  a 
conical  form.  In  many  individuals  the  first  diameter  is  increased,  which 
makes  the  two  sides  of  the  cranium  more  parallel  and  flat  than  usual. 
The  elongation  of  the  transverse  diameter  is  the  most  common,  and  that 
of  the  vertical  the  least  so.  The  capaciousness  of  the  cranium  is  much 
the  same  in  adult  individuals  of  the  same  sex;  from  which  it  may  be 
inferred  that  the  excess  of  one  diameter  is  obtained  generally  at  the 
expense  of  the  other.  The  male  cranium  is  more  capacious  and  thick 
than  the  female. 

The  female  sex  is  less  liable  to  variations  in  these  proportionate  dia- 
meters than  the  male.  Stature  has  but  little  influence  on  the  capa- 
ciousness of  the  cranium,  as  giants  and  dwarfs  have  it  of  the  same  size; 
hence,  the  former  seem  to  have  very  small  heads,  while  the  latter  appear 
to  have  very  large  ones,  the  eye  being  deceived  by  the  relative  magni- 
tude of  their  bodies. 

The  fact  seems  to  be  now  well  ascertained,  that  continued  pressure, 
or  rather,  resistance  in  a  fixed  direction,  made  upon  the  cranium  of  a 
growing  infant  will  change  its  natural  form.  Peculiar  ideas  of  beauty 
have  induced  certain  tribes  of  savages  to  adopt  this  barbarous  and 
unnatural  practice.  The  late  Professor  Wistar1  showed  to  his  class,  in 
1796,  a  Choctaw  Indian  having  this  peculiarity;  and  a  tribe  now  exist- 
ing near  the  sources  of  the  Missouri  continues  the  practice  of  flatten- 
ing both  the  occiput  and  the  os  frontis. 

In  the  Wistar  Museum  we  have  ten  heads2  of  Peruvian  Indians, 
brought  from  the  Pacific  Ocean,  nine  of  which  bear  the  strongest  evi- 
dence of  having  been  flattened  by  pressure,  on  the  os  frontis  and  on 

1  System  of  Anat.  3d  edit.  vol.  i.  p.  73.  1824. 

2  i'resented  by  Dr.  James  Corneck.  U.  S.  Navy,  to  the  late  Dr.  Physick. 


THE  CRANIUM.  145 

the  os  occipitis.1  The  possibility  of  effecting  such  a  change  in  the  form 
of  the  cranium  has  been  strongly  contested;  and  Bichat,  who  admits 
it,  acknowledges  that  he  was  unable  to  produce  like  modifications  in 
puppies,  kittens,  and  India  pigs.  The  singular  change,  however,  which 
is  wrought  upon  the  feet  of  Chinese  ladies  strongly  corroborates  the 
opinion  of  the  head  being  also  susceptible  of  artificial  modification  in  its 
form.2 


SECT.  II. — OF  THE  INDIVIDUAL  BONES  OF  THE  CRANIUM. 

1.  Frontal  Bone  (Os  Frontis,  Frontal). 

The  frontal  bone  forms  the  whole  anterior,  and  a  portion  of  the 
superior,  lateral,  and  inferior  parietes  of  the  cranium.  It  is  symmetri- 
cal, and,  occasionally,  is  completely  divided  into  two. pieces  by  the 
continuation  of  the  suture  between  the  parietal  bones. 

Its  external  face  is  convex,  and  the  internal  concave.  On  the  former 
may  be  observed  a  line,  or  slightly  raised  ridge,  running  on  the  middle 
of  the  bone  from  above  Downwards,  which  is  expressive  of  the  original 
separation  between  its  two  halves.  The  front  surface  of  the  bone  is 
terminated  on  either  side,  below,  by  the  orbitary  or  superciliary  ridge, 
a  sharp  and  arched  elevation,  forming  the  upper  anterior  boundary  to 
the  orbit  of  the  eye.  This  ridge  terminates  outwardly  by  the  external 
angular  process,  which  is  joined  to  the  malar  bone ;  and  inwardly  by 
the  internal  angular  process.  Just  above  the  internal  half  of  the  or- 
bitary ridge  the  bone  is  raised,  by  the  separation  of  its  tables,  into 
the  superciliary  or  nasal  protuberance  or  boss.  Between  the  internal 

1  The  following  letter,  from  a  distinguished  Missionary,  the  Rev.  Mr.  De  Smet,  S.  J.,  who 
had  spent  some  years  among  the  Indians,  on  the  west  side  of  the  Rocky  Mountains,  will  be 
read  with  interest: — 

To  PROFESSOR  WILLIAM  E.  HORNER,  M.  D. 

The  process  of  flattening  the  head  exists  among  several  tribes  on  the  Columbia  River. 
Among  the  Indians  at  the  cascades,  and  Tchenouks  at  Fort  Van  Couver,  I  remarked  several 
babes,  who  were  undergoing  the  barbarous  process.  They  attach  them  to  boards  of  about 
two  feet' in  length.  This  sort  of  cradle  is  covered  with  a  skin,  with  the  hair  outside;  the 
child  is  stretched  on  it;  its  little  arms  are  tied  close  to  the  body  with  soft  leather  bandages; 
another  skin  is  fastened  to  each  extremity  of  the  board  and  covers  the  child.  A  smooth  strip 
of  cedar  bark,  or  of  other  elastic  wood,  four  or  five  inches  broad,  is  fastened  over  the  Ibrehead 
of  the  babe,  so  tight,  that  the  eyes  of  the  infant  appear  to  start  from  their  very  sockets.  In. 
this  painful  situation,  I  was  told,  they  have  them  for  the  space  of  about  a  year,  after 
which  the  head  has  taken  the  form  they  wish  to  give  it,  and  which  they  consider  as  a  mark 
of  distinction  and  of  great  beauty.  This  deformity  in  children  is  very  apparent ;  the 
forehead  and  the  upper  part  of  the  head  are  in  a  straight  line.  The  deformity  disappears 
partly  as  they  grow  old.  These  Indians  have  slaves,  who  are  forbidden,  under  the 
severest  penalty,  to  flatten  the  heads  of  their  offspring.  The  cascade  Indians  and  Tche- 
nouks are  remarkable  for  their  ingenuity  in  constructing  convenient  and  beautiful  canoes, 
nets,  and  wooden  utensils;  they  are  in  no  ways  considered  inferior  to  their  round  head 
neighbors.  Their  constant  intercourse  with  the  whites  has  rendered  them  more  vicious, 
poor  and  indolent;  they  are  much  addicted  to  lying,  stealing  and  immorality. 

P.  I.  DE  SMET. 

PHILADELPHIA,  February  l(M/i,  1843. 

2  In  an  examination  the  author  made  of  an  adult  female  of  this  nation,  Among  Foy,  the 
measurements  were  two  inches  and  one-eighth  from  the  heel  to  the  end  of  the  small  toe  ; 
four  inches  and  three-quarters  from  the  heel  to  the  end  of  the  great  toe;  and  the  circumfer- 
ence of  the  ankle  six  inches  and  six-tenths. 

VOL.  I. — 10 


146  SKELETON. 

angular  processes  a  broad  serrated  surface  exists,  by  which  the  frontal 
bone  is  united  to  the  nasal  bones,  and  to  the  nasal  processes  of  the 
superior  maxillary  bones.-  The  centre  of  this  surface  is  elevated  into 
the  nasal  spine,  which  serves  as  an  abutment  to  the  nasal  bones,  and 
resists  any  force  which  might  tend  to  drive  them  inwards.  On  its 
exterior  lateral  surface,  behind  the  external  angular  process,  the  frontal 
bone  presents  a  concavity  bounded  above  by  a  well-marked  semi- 
circular ridge,  the  temporal  or  parietal,  and  intended  for  the  lodgment 
of  a  part  of  the  temporal  muscle. 

On  each  side  of  the  front  of  the  bone,  near  its  middle,  a  prominence 
exists,  most  frequently  better  marked  in  infancy  than  in  advanced  life, 
and  called  by  the  French  the  frontal  protuberance,  it  being  the  original 
centre  of  ossification  for  that  side  of  the  bone. 

Proceeding  backwards  from  the  inferior  part  of  the  bone  are  the  two 
orbitar  plates  or  processes,  concave  below  and  convex  above.  They  are 

Fig.  33. 


A  view  of  the  lower  part  of  the  Os  Frontis.  1.  Line  of  junction  of  the  two  halves  of  the  bone. 
2.  Frontal  protuberances.  3.  Supra-orbitar  notch.  4.  Nasal  spine,  and  space  filled  by  the  ethmoid 
bone.  5.  Frontal  sinuses.  6.  Orbitar  plates.  7.  External  angular  process  ;  the  depression  for  the 
lachrymal  eland  is  seen  in  the  dark  surface  just  within  the  line  of  reference.  8.  Surface  for  the  tem- 
poral muscle. 

much  thinner  than  other  parts  of  the  bone,  and  are  separated  by  an 
oblong  opening  which  receives  the  ethmoidal  bone.  A  depression  large 
enough  to  receive  the  end  of  a  finger  is  at  the  exterior  anterior  part  of 
the  orbitar  process,  being  protected  by  the  external  angular  process :  this 
depression  contains  the  lachrymal  gland.  Half  an  inch  above  the 
lower  margin  of  the  internal  angular  process,  a  much  smaller  depres- 
sion exists,  occasioned  by  the  tendon  of  the  superior  oblique  muscle, 
where  it  plays  upon  its  trochlea.  In  the  orbitary  ridge,  just  without 
the  latter  depression,  is  the  supra-orbitar  foramen  or  notch,  for  the 
passage  of  the  supra-orbitar  artery  and  nerve. 

The  internal  margins  of  the  orbitar  processes  are  broad  and  cellular 
where  they  join  the  ethmoid  bone  ;  and  at  their  fore  part  is  seen  a  large 
opening  on  each  side  leading  into  the  frontal  sinus.  These  margins, 
in  common  with  the  ethmoid  bone,  form  two  foramina,  one  anterior, 
another  posterior,  and  called  internal  orbitary  or  ethmoidal ;  the  first 
transmits  the  internal  nasal  branch  of  the  ophthalmic  nerve  and  the 
anterior  ethmoidal  artery  and  vein  ;  the  latter  transmits  the  posterior 
ethmoidal  artery  and  vein.  Externally  and  behind,  the  orbitar  process 


THE  CRANIUM.  147 

presents  a  broad  triangular  serrated  surface  for  articulating  with  the 
sphenoid  bone. 

The  interior  or  cerebral  face  of  the  os  frontis  is  strongly  marked  by 
depressions  corresponding  with  the  convolutions  of  the  brain;  and  on  its 
middle  exists  a  vertical  ridge,  becoming  more  elevated  as  it  approaches 
the  ethmoidal  bone.  This  ridge,  the  frontal  crest  ( Crista  Frontalis 
internet),  is  situated  below,  extends  about  one-half  of  the  length  of  the 
bone,  and  terminates,  above,  in  a  superficial  fossa,  made  by  the  longi- 
tudinal sinus  of  the  dura  mater;  at  its  lower  extremity  is  the  foramen 
caecum,  common  to  it  and  the  ethmoid  bone,  and  which  is  occupied  by 
a  process  from  the  great  falx  of  the  dura  mater,  and  also  affords  pas- 
sage to  some  very  small  veins,  which  go  from  the  nostrils  to  the  com- 
mencement of  the  longitudinal  sinus.1 

The  frontal  sinuses  consist  in  one  or  more  large  cells,  placed  beneath 
the  nasal  protuberances.  There  is  a  very  great  variety  in  their  mag- 
nitude and  extent;  sometimes  they  proceed  as  far  outwards  as  the 
external  angular  process,  and  backwards  for  half  an  inch  into  the  orbi- 
tar  plates.  In  a  few  instances  in  the  adult  they  do  not  exist,  but  the 
cases  are  very  uncommon.  The  cells  of  the  opposite  sides  have  &  com- 
plete partition.  They  communicate  with  the  cavity  of  the  nose  through 
the  anterior  ethmoidal  cells. 

With  the  exception  of  the  inferior  part,  where  the  processes  and 
sinuses  exist,  the  os  frontis  is  of  a  very  uniform  thickness,  and  the 
diploic  or  cellular  structure  is  found  constantly  between  its  external 
and  internal  faces. 

This  bone  is  united  to  the  parietal,  ethmoidal,.  and  sphenoidal  of  the 
cranium;  and  to  several  bones  of  the  face. 

2.  Parietal  Bones  ( Ossa  Parietafoa>  0$  Purietaux)* 

These  bones,  it  has  been  stated,  form  the  superior  and  lateral  parts 
of  the  middle  of  the  cranium.  They  are  quadrilateral,  convex  exter- 
nally, and  concave  internally.  Their  external  and  internal  tables  are 
separated  by  a  diploic  structure,  which,  from  being  more  abundant  at 
the  superior  half  of  the  bone,  occasions  there  an  increased  thickness. 

The  external  surface  of  the  parietal  bone  is  raised  about  its  middle  into 
the  parietal  protuberance.  Just  below  this  protuberance  is  an  arched, 
rough,  broad,  but  slightly  elevated  surface,  the  parietal  ridge,  marking  the 
origin  of  the  temporal  fascia  and  muscle,  and  continuous  with  the  ridge 
on  the  side  of  the  frontal  bone.  The  internal  surface  of  the  bone  is 
marked  by  the  convolutions  of  the  brain;  there  is  also  a  number  of 
furrows  upon  it,  having  an  arborescent  arrangement,  and  produced  by 
the  ramifications  of  the  middle  artery  of  the  dura  mater.  The  fur- 
rows all  proceed  from  two  larger  ones  at  the  inferior  part  of  the  bone. 
Of  the  two  furrows,  the  foremost  may  be  traced  from  the  greater  wing 
of  the  sphenoidal  bone,  and  runs  near  to  and  nearly  parallel  with  the 
anterior  margin  of  the  parietal,  being  not  unfrequently  at  the  latter 

1  Portal,  Anat.  Medicale. 


148  SKELETON. 

point  converted  into  a  perfect  tube  by  the  deposition  of  bone  all 
around  the  artery;  the  other  furrow,  passing  from  the  squamous  por- 
tion of  the  temporal,  is  commonly  a  little  behind  the  middle  of  the 
parietal  bone,  and  inclines  towards  its  posterior  superior  angle ;  the 
general  course  of  the  branches  of  these  furrows  is  upwards  and  back- 
wards. The  internal  face  of  the  parietal  bone  also  presents  an  imper- 
fect fossa  at  its  superior  margin,  which  is  completed  by  junction  with 
its  fellow,  and  accommodates  the  longitudinal  sinus  of  the  dura  mater. 
Near  this  edge  it  is  not  uncommon  to  see  one  or  more  small  irregular 
pits  passing  through  the  internal  table,  and  looking  somewhat  ulcer- 
ated: these  are  formed  by  the  glands  of  Pacchioni,  in  the  dura  mater. 
At  the  inferior  posterior  corner  of  the  bone,  there  is  also  a  fossa, 
which  is  made  by  the  lateral  sinus  of  the  dura  mater. 

The  superior,  the  posterior,  and  the  anterior  margins  of  the  parietal 
bone  are  regularly  serrated,  and  nearly  straight.  The  inferior  mar- 
gin is  concave,  presenting  a  thin,  bevelled,  radiated  surface  before,  for 
articulating  with  the  squamous  portion  of  the  temporal  bone:  behind 
this  concavity,  the  angle  of  the  bone  is  truncated  and  serrated,  for 
articulating  with  the  angular  portion  of  the  os  temporis.  The  anterior 
inferior  angle  is  the  most  remarkable,  from  its  being  elongated  so  as 
to  join  the  sphenoid  bone  in  the  temporal  fossa. 

A  foramen,  called  parietal,  is  found  at  the  superior  margin  of  this 
bone,  nearer  to  its  posterior  than  to  the  anterior  edge;  it  transmits  an 
artery  between  the  integuments  and  dura  mater,  and  also  a  vein  from 
the  integuments  to  the  longitudinal  sinus.  M.  Portal  says,  that  in 
some  protracted  headaches  this  vein  swells  considerably;  and  that  he 
has  seen  much  good  in  such  cases  arise  from  the  application  of  leeches 
to  the  part:  he  has  also  seen,  in  a  child,  its  tumefaction  the  precursor 
of  the  paroxysms  of  epilepsy. 

The  parietal  bone  articulates  with  its  fellow,  with  the  frontal,  the 
sphenoid,  the  temporal,  and  the  occipital  bones. 

3.   Occipital  Bone  (Os  Occipitis,  Occipital). 

This  bone  is  quadrilateral,  and  resembles  a  trapezium.  It  is  convex 
externally,  and  concave  internally ;  but  both  of  these  surfaces  are  much 
modified  by  ridges  and  processes.  Its  thickness  is  also  very  unequal ; 
though,  like  the  other  bones,  it  has  two  tables,  with  an  intermediate 
diploe.  It  is  so  placed  as  to  form  a  considerable  share  of  the  posterior 
and  inferior  parietes  of  the  cranium. 

The  foramen  magnum  is  found  in  the  lower  half  of  this  bone,  and 
constitutes  a  very  conspicuous  feature  in  it.  This  hole  is  oval,  the 
long  diameter  extending  from  before  backwards.  Its  anterior  inferior 
margin,  on  either  side,  is  furnished  with  a  condyle  for  articulating  with 
the  first  vertebra  of  the  neck.  These  condyles  are  long  eminences  tipped 
with  cartilage,  which  converge  forwards,  so  that  lines  drawn  through 
their  length  would  meet  an  inch  in  front  of  the  foramen  magnum  ;  they 
recede  behind;  their  internal  margins  are  deeper  than  their  external. 


THE  CRANIUM. 


149 


The  condition  of  their  articular  surfaces  is,  therefore,  such  that  they 
permit  flexion  and  extension  of  the  head,  but  not  rotation.  The  ante- 
rior edge  of  the  foramen  is  thicker  than  the  posterior.  This  foramen 
is  occupied  by,  or  transmits  the  medulla  oblongata,  the  vertebral  arte- 
ries and  veins,  and  the  spinal  accessory  nerves. 

The  external  surface  of  the  occiput  presents,  half  way  between  the 
foramen  magnum  and  the  upper  angle  of  the  bone,  the  external  occipi- 
tal protuberance  (Spina  externa),  from  the  lower  part  of  which  a  small 
vertical  ridge,  the  occipital  crest  (Crista  externa  occipitalis),  is  extended 
in  the  middle  line  to  that  foramen.  Into  the  ridge  is  inserted  the  Liga- 
mentum  Nuchse.  From  either  side  of  the  protuberance  an  arched  ridge 
is  extended  to  the  lateral  angle  of  the  bone ;  it  is  the  superior  semi-circu- 
lar ridge  or  line  from  which  arise  the  occipito-frontalis  and  the  trape- 
zius  muscles,  and  into  it  is  inserted  a  part  of  the  sterno-cleido-mastoideus. 
Below  this,  about  an  inch,  is  the  inferior  semicircular  ridge,  more  pro- 
tuberant, but  not  so  distinctly  marked  in  its  whole  course.  Into  the 
inner  space,  between  the  upper  and  lower  ridges,  is  inserted  the  corn- 
plexus  muscle,  and  into  Jhe  outer  space  between  the  same  the  splenius 
muscle.  The  lower  ridge  is  principally  occupied  by  the  insertion  of  the 
superior  oblique  muscle  of  the  neck. 

The  inner  space  between  this  ridge  and  the  great  foramen  gives  in- 
sertion to  the  rectus  posticus  minor,  and  the  outer  space  affords  inser- 
tion to  the  rectus  posticus  major.  Into  a  small  elevation,  leading  from 
the  outside  of  the  condyle  directly  to  the  margin  of  the  bone,  is  inserted 
the  rectus  capitis  lateralis. 

In  a  depression  behind  each  condyle  is  the  posterior  condyloid  fora- 
men, which  conducts  a  cervical  vein  to  the  lateral  sinus.  Passing  through 
the  base  of  the  condyle,  and  having  its  orifice  in  front,  is  the  anterior 
condyloid  foramen,  for  conducting  the  hypoglossal  nerve  to  the  tongue. 

That  part  of  the  bone  before  the  condyles  is  the  cuneiform  or  basilar 
process ;  the  base  of  which  is  marked  by  depressions  for  the  insertion 
of  the  recti  muscles,  which  are  situated  on  the  front  of  the  cervical 
vertebrae ;  and  its  fore  part,  which  is  truncated  at  the  end,  overhangs 
the  pharynx,  and  is  placed  against  the  body  of  the  sphenoid  bone.  The 
superior  external  part  of  the  os  occipitis  is  uniformly  convex,  being 
covered  by  the  occipito-frontalis. 

The  internal  surface  of  the  os  occipitis  is  strongly  impressed  by 
ridges  and  depressions.  On  that  portion  of  it  behind  the  great  fora- 
men, is  a  rectangular  cross,  forming  at  its  centre  the  internal  occipital 
protuberance  (Spina  internet),  which  is  much  larger  than  the  external. 
The  upper  limb  of  the  cross  is  marked  by  a  fossa  for  the  posterior  end 
of  the  longitudinal  sinus  ;  the  two  horizontal  limbs  are  also  marked, 
each  by  its  respective  fossa,  which  receives  the  corresponding  lateral 
sinus.  The  right  fossa  is  frequently  the  largest.  The  inferior  vertical 
limb  of  the  cross  (Crista  interna]  has  attached  to  it  the  small  falx  of 
the  dura  mater,  and  is  slightly  depressed  by  a  small  sinus.  The  spaces 
between  the  limbs  of  the  cross  are  much  thinner  than  other  pans  of 
the  bone,  and  present  broad  concavities,  the  two  superior  of  which 


150  SKELETON. 

Fig.  34. 


The  internal  surface  of  the  Occipital  Bone. — 1.  Foramen  magnum.  2.  Ridge  for  the  falx 
minor,  and  depression  for  a  small  sinus.  3.  Internal  occipital  protuberance,  and  the  depression 
strongly  marked  in  this  bone  for  the  torcular  Hierophyli.  4,4.  Lateral  limbs  of  the  occipital  cross, 
and  depression  for  the  lateral  sinus.  5.  Margin  for  the  parietal  bone.  6.  Jugular  eminence. 
7.  Jugular  fossa,  for  the  transmission  of  the  jugular  vein,  and  the  eighth  pair  of  nerves.  8.  Internal 
orifice  of  the  posterior  condyloid  foramen.  9.  Margin  for  the  petrous  portion  of  the  temporal  bone. 
10.  The  condyles.  11.  The  surface  for  the  sphenoid  bone;  or,  the  anterior  extremity  of  the  basilar 
process.  12.  Exterior  ed^-e  of  the  basilar  process.  13.  Margin  for  the  mastoid  portion  of  the  tem- 
poral bone.  14.  Depression  for  the  cerebellum.  15.  Degression  for  ihe  posterior  lobes  of  the  cere- 
brum. 

(the  fossae  cerebri)  receive  the  posterior  lobes  of  the  cerebrum,  and  the 
two  inferior  (the  fossae  cerebelli)  the  lobes  of  the  cerebellum. 

The  superior  face  of  the  cuneiform  process  is  excavated,  longitu- 
dinally, by  the  fossa  basilaris,  to  receive  the  medulla  oblongata.  On 
each  side  of  the  foramen  magnum,  a  short  curved  fossa  is  observed, 
which  receives  the  inferior  end  of  the  lateral  sinus  of  the  dura  mater, 
just  before  its  exit  from  the  cranium. 

The  two  superior  margins  of  the  occipital  bone  are  regularly  serrated. 
The  inferior  margins  have  each,  in  their  centre,  a  process  termed  the 
jugular  eminence,  in  front  of  which  is  a  rounded  notch  (Incisura  jugu- 
laris\  forming  a  part  of  the  jugular  fossa;  this  notch  is  continuous  with 
the  semicircular  fossa  which  holds  the  inferior  end  of  the  lateral  sinus, 
and  transmits  the  internal  jugular  vein  and  eighth  pair  of  nerves.  The 
edge  of  the  bone  above  this  eminence  is  serrated,  but  below  it  is  rather 
smooth  and  rounded,  being  parallel  with  the  temporal  bone,  and  having 
an  imperfect  adhesion  to  the  petrous  part  of  it,  before  the  jugular  fossa. 


The  occipital  bone  articulates  above  with  the  parietal;  laterally  with 
the  temporal,  and  in  front  with  the  sphenoidal. 


4.   Temporal  Bones  ( Ossa  Temporum,  Tewporaux]. 

These  bones  form  portions  of  the  inferior  lateral  parietes,  and  of  the 
base  of  the  cranium. 

Their  figure  is  very  irregular.  Their  circular  anterior  portion  is  called 
squamous:  behind  it,  is-  the  mastoid,  and  between  the  others  is  the 
petrous. 

The  squamous  portion  is  thinner  than  the  other  bones  of  the  cranium 


THE  CRANIUM.  151 

that  have  been  described;  but  the  temporal  muscle  and  fascia  cover 
it,  so  as  to  contribute  to  the  protection  of  the  brain.  Its  exterior 
surface  is  smooth  and  slightly  convex.  The  interior  is  formed  into 
depressions  by  the  convolutions  of  the  brain.  At  the  anterior  inferior 
part  of  the  latter  surface,  a  groove  is  made  by  the  middle  artery  of  the 
dura  mater,  immediately  after  it  gets  from  the  foramen  spinale  of  the 
sphenoid  bone  on  its  way  to  the  parietal.  This  groove  bifurcates;  one 
branch  runs  backwards  to  join  the  posterior  groove  of  the  parietal 
bone,  and  the  other  ascends  to  join  the  anterior  groove  of  the  same, 
frequently,  however,  impressing  the  top  of  the  great  wing  of  the 
sphenoid,  just  before  it  reaches  the  parietal.  The  greater  part  of  the 
circumference  of  this  portion  is  sloped  to  a  sharp  edge,  but  at  the  ante- 
rior inferior  part  it  is  serrated  and  thicker.  On  the  outside  of  the  latter, 
is  the  glenoid  cavity,  for  articulating  with  the  lower  jaw :  the  length  of 
it  is  transverse,  with  a  slight  inclination  backwards  and  inwards,  so 
that  a  line  drawn  through  it  would  strike  the  anterior  margin  of  the 
foramen  magnum  occipitis.  The  anterior  margin  of  this  cavity  is 
formed  by  a  tubercle,  on  which  the  condyle  of  the  lower  jaw  rises 
when  the  mouth  is  widely  opened.  The  outer  margin  of  the  glenoid 
cavity  is  formed  by  the  root  of  the  zygomatic  process.  The  zygomatic 
process  has  a  broad  horizontal  root,  from  which  it  extends  outwardly, 
and  then  diminishing,  runs  forward  to  join  the  malar  bone.  Posterior 
to  the  root  of  the  zygomatic  process,  a  small  ascending  groove  may  be 
occasionally  seen,  made  by  the  middle  temporal  artery. 

The  mastoid  portion  of  the  temporal  bone  is  thick  and  cellular.  Its 
upper  part  forms  an  angle,  which  is  received  between  the  parietal  and 
occipital  bones  :  both  margins  of  this  angle  are  serrated.  Below,  is  the 
mastoid  process,  a  large  conical  projection  eight  lines  long,  into  which 
are  inserted  the  sterno-mastoid  and  trachelo-mastoid  muscles.  At  the 
inner  side  of  its  base  is  a  fossa  affording  origin  to  the  digastric  muscle. 
The  inner  face  of  the  mastoid  portion  is  marked  by  a  deep  large  fossa 
for  the  lateral  sinus  of  the  dura  mater.  In  the  posterior  part  of  the 
suture,  uniting  the  mastoid  portion  and  the  occipital  bone,  or  in  the 
former  near  the  suture,  is  the  mastoid  foramen,  for  conducting  a  vein 
from  the  integuments  into  the  lateral  sinus. 

The  cells  in  the  mastoid  portion  are  large  and  numerous,  and  obtain 
the  name  of  sinuses ;  they  communicate  with  the  tympanum  by  one 
large  orifice.  On  the  outer  side  of  these  sinuses  a  thin  diploic  struc- 
ture is  observable  in  some  heads. 


The  petrous  portion  of  the  temporal  bone  is  a  triangular  pyramid 
arising  by  a  broad  base  from  the  inner  side  of  the  mastoid  and  squa 
mous  portions.  It  ,is  fixed  obliquely  forwards,  between  the  sphenoid 
and  occipital  bones.  Its  anterior  surface  is  marked  by  the  convolu- 
tions of  the  brain.  Near  the  centre  of  this  surface,  and  having  a  little 
superficial  furrow  leading  to  it,  is  a  small  foramen  called  the  hiatus 
Fallopii,  through  which  passes  the  Vidian  nerve.  The  posterior  surface 
of  the  petrous  portion  presents  a  large  foramen,  the  meatus  auditorius 
internus,  through  which  pass  the  seventh  or  the  auditory  and  the  facial 
nerve.  Half  an  inch  behind  this  orifice,  is  a  very  small  one,  overhung 


:* 


152  SKELETON. 

by  a  flat  shelf  of  bone  ;  this  is  called  the  aqueduct  of  the  vestibule. 
Just  above  the  meatus  auditorius  internus  is  a  foramen  more  patulous 
than  the  aqueduct,  for  transmitting  small  blood-vessels. 

In  the  base  of  the  petrous  portion,  between  the  mastoid  and  zygo- 
matic  processes,  is  the  meatus  auditorius  externus,  a  large  opening 
conducting  to  the  tympanum.  It  is  oval,  about  half  an  inch  deep, 
and  varies  much  in  its  size  in  different  subjects :  its  margin  is  called 
the  auditory  process,  the  lower  part  of  which  is  very  rough,  for  at- 
taching the  cartilage  of  the  external  ear. 

The   lower   surface  of  the  petrous  bone  is  exceedingly  irregular. 
Immediately  below  the  meatus  auditorius  externus,  is  the  parotid  de- 
Fig.  35. 


The  internal  surface  of  the  Left  Temporal  Bone.  1.  Squamous  portion.  2.  Mastoid  portion. 
3.  Petrous  portion.  4.  Groove  for  the  posterior  branch  of  the  middle  artery  of  the  dura  mater. 
5.  Bevelled  edge  of  the  squamous  portion.  6.  Zygomatic  process.  7.  Digastric  fossa.  8.  Occi- 
pital margin.  9.  Groove  for  the  lateral  sinus.  10.  Position  of  the  superior  petrous  sinus. 
11.  Opening  of  the  carotid  canal.  12.  Meatus  auditorins  internus.  13.  Supposed  aqueduct  of  the 
vestibule.  14.  Styloid  process.  15.  Stylo-mastoid  foramen.  16.  Carotid  foramen.  17.  Spine  sepa- 
rating the  eighth  pair  of  nerves  from  the  jugular  vein.  The  dark  depression  immediately  in  advance 
of  the  number,  is  the  opening  of  the  aqueduct  of  the  cochlea.  18.  Points  to  the  Vidian  foramen,  on 
the  anterior  surface  of  the  petrous  portion.  19.  Origin  of  the  levator  palati  and  tensor  tympam 
mugcles. 

pression  which  seems  like  a  part  of  the  glenoid  cavity,  but  is  not,  inas- 
much as  it  does  not  form  a  portion  of  the  articular  surface  for  the  lower 
jaw,  but  simply  allows  room  for  its  motions,  the  parts  which  it  contains 
(consisting  of  vessels,  and  a  portion  of  the  parotid  gland)  being  pressed 
back  when  the  jaw  opens.  Between  this  cavity  and  the  glenoid  is  the 
glenoidal  fissure  (Fissura  Grlasseri),  separating  the  petrous  from  the 
squamous  bone.  In  this  fissure  is  a  foramen,  which,  leading  to  the 
tympanum,  contains  the  processus  gracilis  of  the  malleus  with  its 
muscle,  and  the  chorda  tympani.  The  posterior  margin  of  the  parotid 
epression  in  the  petrous  bone  is  made  by  a  long  rough  ridge,  called 
rocessus  vaginalis ;  just  behind  which,  and  partially  surrounded  by  it, 
the  styloid  process.  The  styloid  process  is  round,  tapering,  and  an 
inch  and  a  half  long ;  but  frequently  absent  in  prepared  skulls,  from 
accidental  fracture  and  from  being  in  a  cartilaginous  state.  From  it 
the  styloid  muscles  arise. 

Behind  the  root  of  the  styloid  process,  is  the  stylo-mastoid  foramen, 
which  transmits  the  portio  dura  or  facial  nerve   to  the  face.     Just 


THE  CRANIUM.  153 

within  the  styloid  process  and  this  foramen  is  a  deep  depression, 
called  jugular  fossa,  large  enough  to  receive  the  tip  of  the  little  finger. 
The  fossa,  along  with  the  corresponding  one  in  the  os  occipitis,  is  occu- 
pied by  the  internal  jugular  vein  and  the  eighth  pair  of  nerves.  Im- 
mediately before  the  lower  end  of  this  fossa  is  the  foramen  caroticum, 
being  the  lower  orifice  of  a  crooked  canal,  which  terminates  at  the  apex 
of  the  petrous  bone,  and  transmits  the  carotid  artery  and  the  upper 
part  of  the  sympathetic  nerve.  At  the  inner  side  of  the  carotid  canal, 
a  superficially  serrated  surface  is  perceived,  which  receives  the  adjoin- 
ing edge  of  the  basilar  process  of  the  occipital  bone.  Just  in  advance 
of  the  inner  part  of  the  jugular  fossa  is  a  small  spine  of  bone,  at  the 
foot  of  which  is  a  pit,  containing  the  orifice  of  the  aqueduct  of  the 
cochlea.  This  spine  separates  the  eighth  pair  of  nerves  from  the  inter- 
nal jugular  vein. 

In  the  angle  between  the  squamous  and  petrous  parts,  within  the 
glenoid  fissure,  is  the  orifice  of  the  Eustachian  tube.  The  tube  is 
divided  longitudinally  by  a  bony  partition.  The  upper  division  con- 
tains the  tensor  tympani  muscle. 

A  small  groove  exists  along  the  superior  angle  of  the  petrous  bone ; 
and  another  along  the  inferior  angle,  adjoining  the  basilar  process  of 
the  occipital  bone,  and  formed  in  part  by  it :  they  are  made  by  the 
superior  and  the  inferior  petrous  sinuses. 

The  temporal  bone  articulates  with  the  occipital,  the  parietal,  the 
sphenoid,  and  the  malar. 

5.  Sphenoid  Bone  (Os  Sphenoides,  Sphenoide}. 

The  sphenoid  is  a  symmetrical,  but  very  irregular  bone,  placed 
transversely  in  the  middle  of  the  base  of  the  cranium. 

It  consists  of  a  cuboidal  body  in  the  centre ;  of  a  very  large  process 
called  the  great  wing,  spreading  laterally  to  a  considerable  distance  on 
either  side  of  the  body ;  and  it  has,  also,  a  number  of  angular  margins 
and  additional  processes  about  it. 

Fig.  36. 


* 


'  The  anterior  and  inferior  surface  of  the  Sphenoid  Bone.  1,  1.  Apophyses  of  Ingrassias.  2,2.  The 
great  wings.  3.  Crista  sphenoidalis.  4.  Azygous process.  5.  Sphenoidal  cells,  after  the  abolition  of 
the  pyramids  of  Wistar.  6.  Posterior  clinoid  process.  7.  Sphenoidal  foramen.  8.  Foramen  rotun- 
dum.  9.  Orbital  face.  10.  Surface  for  the  temporal  muscle.  11.  Styloid  process.  12.  External  ptery- 
goid  process.  13.  Internal  pterygoid  process.  14.  Pterygoid  foramen.  15.  Articular  surface  for 
the  OB  frontis.  16.  Points  to  the  sella  turcica. 


154  SKELETON. 

In  regard  to  the  body  of  the  sphenoid  bone,  from  its  upper  anterior 
part  arise,  one  on  each  side,  the  apophyses  of  Ingrassias,  or  the  little 
wings.  These  wings  have  a  broad  horizontal  base,  and  extending 
themselves  outwardly,  terminate  in  a  sharp  point.  Their  anterior  edge 
is  serrated  for  articulating  with  the  os  frontis  ;  the  posterior  edge  is 
smooth.  Between  these  two  wings,  in  front,  is  a  prominence  united  to 
the  ethmoid  bone.  The  base  of  the  wing  is  perforated  by  the  foramen 
opticum,  for  transmitting  the  optic  nerve  with  the  ophthalmic  artery. 
Below  and  behind  this  foramen,  the  little  wing  terminates  in  a  point, 
called  the  anterior  clinoid  process.  Between  the  foramina  optica  is  a 
ridge  of  bone,  sometimes  called  processus  olivaris,  and  just  above  the 
ridge  a  groove,  made  by  the  optic  nerves  where  they  unite.  Behind 
the  ridge  is  a  depression,  the  Sella  Turcica,  for  containing  the  pituitary 
gland.  This  depression  is  bounded  behind  by  a  very  elevated  trans- 
verse ridge,  called  the  posterior  clinoid  process,  on  the  posterior  face  of 
which  again  is  a  well-marked  acclivity  called  the  Clivus,  upon  which 
touches  the  Pons  Varolii.  At  either  extremity  of  the  base  of  the  clivus, 
a  groove  (sulcus  caroticus)  is  made  by  the  carotid  artery,  which  groove 
may  be  traced  indistinctly  by  the  side  of  the  sella  turcica  and  under  the 
anterior  clinoid  process,  where  it  forms  a  notch,  and  sometimes  a 
foramen. 

The  posterior  face  of  the  body  of  the  sphenoid  bone  presents  a  flat 
surface  for  articulating  with  the  cuneiform  process  of  the  occipital. 
In  the  adult,  these  bones  are  consolidated  at  this  junction.  The  infe- 
rior part  of  the  body  of  the  sphenoid  presents  a  rising  in  its  middle 
called  the  sphenoidal  or  azygous  process  (Rostrum  sphenoidale),  being 
for  articulation  with  the  vomer;  this  process  is  continued  forward  to 
the  top  of  the  bone  as  a  sharp  ridge  (Crista  sphenoidalis),  which  joins 
with  the  nasal  septum  of  the  ethmoid.  On  each  side  of  this  process, 
in  front,  is  the  orifice  of  the  sphenoidal  cells.  These  cells  consist, 
most  commonly,  of  one  on  each  side,  and  are  separated  by  a  bony 
partition.  In  the  very  young  bone  they  are  not  formed.  The  body 
of  the  sphenoid  undergoes  so  many  changes,  between  early  infancy 
and  adult  life,  by  the  conversion  of  its  diploic  structure  into  sinuses  or 
cells,  and  is  also  so  much  modified  in  different  individuals,  that  a  gene- 
ral description  of  it  will  not  answer  for  all  specimens. 

The  two  great  wings  arise  from  the  sides  of  the  body  of  the  sphenoid 
by  a  small  irregular  base.  From  their  lower  part  project  downwards, 
on  either  side,  the  two  pterygoid  processes  called  external  and  internal. 
These  processes  have  a  common  base,  are  partially  separated  behind 
by  a  groove  called  pterygoid  fossa,  and  below  by  a  notch  (incisura 
ygoideci).  The  internal  (ala  internet)  is  the  longer,  and  is  termi- 
ated by  a  hook,  on  the  outer  side  of  which  is  a  trochlea  made  by  the 
endon  of  the  circumflexus  palati  muscle.  The  external  pterygoid 
process  (ala  externa)  is  the  broader.  By  applying  together  the  tem- 
poral and  sphenoid  bones,  a  groove,  common  to  the  two,  leading  to 
the  Eustachian  tube,  will  be  seen.  This  groove  is  continued  obliquely 
across  the  root  of  the  internal  pterygoid  process,  and  indicates  the 
course  and  surface  of  attachment  of  the  cartilaginous  portion  of  the 
Eustachian  tube.  The  internal  pterygoid  process  sends  out  from  its 
base  a  small  shelf  of  bone  separated  by  a  fissure  from  the  under  part 


THE  CRANIUM.  155 

of  the  body  of  the  sphenoid.     The  posterior  edge  of  the  vomer  rests 
against  this  projection.     The  fissure  is  filled  up  in  advanced  life. 

The  great  wings  of  the  sphenoid  bone  present  three  faces.  One  is 
anterior,  and  called  orbital  from  its  forming  a  part  of  the  orbit;  an- 
other is  external,  and  called  temporal;  and  the  third  is  towards  the 
brain,  and  forms  a  considerable  part  of  the  fossa  for  containing  its 
middle  lobe.  The  orbital  face  is  square  and  slightly  concave.  The 
temporal  face  is  an  oblong  concavity,  at  the  lower  part  of  which  is  a 
triangular  process,  giving  an  origin  to  the  external  pterygoid  muscle. 
The  cerebral  face  is  concave  and  marked  by  the  convolutions  of  the 
brain,  as  well  as  by  a  furrow  above,  made  by  the  anterior  branch  of 
the  great  artery  of  the  dura  mater,  as  it  passes  from  the  temporal  bone 
to  the  temporal  angle  of  the  parietal.  The  inferior  portion  of  the 
great  wing  is  elongated  backwards  into  a  horizontal  angle,  called  the 
spinous  process,  which  is  fixed  between  the  petrous  and  squamous  por- 
tions of  the  temporal  bone.  From  the  point  of  the  spinous  process, 
projects  downwards  the  styloid  process.  The  great  wing  presents  a 
triangular  serrated  surface  above,  at  its  outer  end,  by  which  it  articu- 
lates with  the  os  fron\is ;  just  below  this,  in  front,  is  a  short  serrated 
edge,  by  which  it  articulates  with  the  malar  bone.  The  tip  of  the 
large  wing  generally  articulates  with  the  parietal  bone,  but  in  some 
cases  the  parietal  does  not  come  that  far  forward ;  and  externally  is  a 
semicircular  serrated  edge  by  which  the  great  wing  articulates  with  the 
squamous  portion  of  the  temporal  bone. 

Between  the  apophyses  of  Ingrassias  and  the  greater  wings  is  the 
foramen  sphenoidale,  called  also  foramen  lacerum  superius  of  the  orbit. 
It  is  broad  near  the  body  of  the  bone,  and  becomes  a  mere  slit  a\  the 
extremity  of  the  little  wing.  Through  it  pass  the  third,  the  fourth, 
the  first  branch  of  the  fifth,  and  the  sixth  pair  of  nerves.  Two  lines 
below  the  base  of  this  hole  is  the  foramen  rotundum,  for  transmitting 
the  second  branch  of  the  fifth  pair  of  nerves.  Eight  lines,  or  there- 
abouts, behind  the  foramen  rotundum  is  the  foramen  ovale,  for  trans- 
mitting the  third  branch  of  the  fifth  pair  of  nerves.  Two  lines  behind 
the  foramen  ovale  is  the  foramen  spinale,  for  transmitting  the  middle 
artery  of  the  dura  mater.  In  the  under  part  of  the  bone,  and  passing 
through  the  root  of  the  pterygoid  processes,  is  the  foramen  pterygoideum, 
also  called  the  Vidian  canal,  for  transmitting  the  pterygoid  nerve;  it 
being  a  recurrent  branch  of  the  second  branch  of  the  fifth  pair  of 
nerves.  Along  the  posterior  border  of  the  spinous  process  and  the 
external  pterygoid  is  a  notch,  subtended  by  ligament,  sometimes  a  per- 
fect foramen  of  large  size;  it  is  the  foramen  pterygo-spinosum  (se 
interruption)  of  Fasebeck,  and  transmits  a  nervous  filament  to  t 
ganglion  oticum. 

The  sphenoid1  bone  articulates  above  and  in  front  with  the  vomer, 
the  frontal,  ethmoidal,  malar,  and  parietal  bones;  laterally  with  the 
temporal;  behind  with  the  occipital,  and  by  its  pterygoid  processes  with 
the  palate  bones. 


er- 

eii^^ 

er,^ 


1  This  bone  is,  by  some  anatomists,  described  in  common  with  the  os  occipitis,  as  the 
o«  basiluie,  or  foundation  bone,  in  consequence  of  their  early  junction  into  a  single  piece. 


156  SKELETON. 

The  Pieces  of  the  Cranium  are  considered,  by  some  naturalists,  as 
equivalent  to  three  vertebrae  ;  the  first  is  one  formed  by  the  occiput ;  the 
second  by  the  sphenoidal  bone,  the  temporal  and  the  two  ossa  parietalia  ; 
and  the  third  by  the  sphenoid,  frontal  and  ethmoid.  In  the  sheep,  dog, 
and  in  the  pig,  this  analogy  is  more  evident  than  in  the  human  subject. 

An  occipital  bone,  being  the  first  cranial  vertebra,  exhibits  all  the 
elements  of  a  vertebra,  as  follows :  the  foramen  magnum  corresponds 
•with  the  spinal  canal ;  the  basilar  process  is  the  body  of  a  vertebra ; 
the  condyles  the  articulating  processes;  the  portion  exterior  and  lateral 
to  them,  or  the  jugular  eminences,  are  the  transverse  processes,  and  the 
back  part  of  the  bone  is  the  vertebral  arch  and  spinous  process. 

The  second  cranial  vertebra  is  formed  as  follows :  the  parietal,  the 
squamous,  and  the  great  wings  of  the  sphenoid,  correspond  with  the 
arch  of  a  vertebra.  The  body  of  the  sphenoid  is  the  body  of  a  vertebra 
modified,  while  the  glenoid  cavities  and  the  mastoid  processes  corre- 
spond with  the  articular  and  transverse  processes. 

The  front  of  the  body  of  the  sphenoidal,  and  the  ethmoidal  make  the 
body  of  the  third  cranial  vertebra,  and  the  os  fronds  its  remaining 
portions. 

This  analogy,  first  indicated  by  Dumeril,  was  still  further  explained 
by  Geoffrey  St.  Hilaire.  These  pieces  have  been  called  Cranial  Zones 
by  Cuvier,1  which  is  a  less  forced  expression  than  the  other,  and  ex- 
plains well  the  simple  fact  of  their  ring-like  condition.  In  following 
out  this  idea,  it  would  not  be  a  bad  substitution  of  terms  to  call  the 
cranial  pieces  the  cerebral  zones,  and  the  pieces  of  the  vertebral 
column  the  spinal  zones,  from  their  surrounding  the  spinal  marrow :  in 
each  case,  the  pieces  having  been  modified,  so  as  to  suit  the  especial 
circumstances  of  contents,  muscular  attachment,  and  support.  The 
term  vertebra,  derived  from  the  function  of  turning,  is  inapplicable  to 
many  of  the  pieces  of  the  spine  in  the  human  subject,  whereas  zone 
or  ring  is  everywhere  appropriate. 

6.  Ethmoid  Bone  (Os  Ethmoides,  Ethmoide). 

This  bone  is  -placed  between  the  orbitar  processes  of  the  os  frontis, 
and,  as  has  been  stated,  fills  the  space  between  them.  It  is  cuboidal, 
extremely  cellular,  and  light. 

The  horizontal  portion  between  the  orbitar  processes  is  the  cribriform 
plate  (Lamina  cribrosa],  called  so  from  its  numerous  perforations.  This 
is  divided,  longitudinally,  above  and  below,  by  a  vertical  process  or 
•late ;  and  from  the  under  surface  on  each  side,  is  suspended  the  cel- 
ular  or  lateral  portion  (Labyrinthus). 

The  vertical  process,  as  placed  on  the  superior  face  of  the  cribriform 
ate,  is  the  crista  galli,  which  extends  sometimes  from  the  back  to  the 
front  of  this  plate,  and  is  thickest  in  the  middle.  The  commencement 
of  the  great  falx  arises  from  it,  and  occasionally  it  contains  a  cell  or 
sinus,  opening  into  the  nose.  Between  the  front  of  the  crista  galli  and 
the  os  frontis,  is  the  foramen  csecum,  already  described.  On  either 
side  of  the  crista  galli,  the  cribriform  plate  is  depressed  into  a  gutter  for 

1  See  Regne  Animal,  torn.  i. 


THE  CRANIUM.  157 

holding  the  bulb  of  the  olfactory  nerve,  and  is  perforated  with  many 
holes  for  transmitting  its  ramifications.  The  anterior  foramen  on 
each  side  is  oval,  and  transmits  to  the  nose  the  internal  nasal  nerve, 
after  it  has  got  into  the  cranium  through  the  anterior  internal  orbitar 
foramen.1  The  margins  of  the  cribriform  plate  show  many  imperfect 

Fig.  37. 


The  Ethmoid  Bone  seen  from  above  and  behind.  1.  The  nasal  lamella.  2,  2.  The  cellular  portions ; 
the  numbers  are  placed  on  the  posterior  border  of  the  lateral  part  of  each  side.  3.  The  crista  galli. 
4.  The  cribriform  plate  of  the  left  side,  pierced  by  its  foramina.  5.  The  hollow  space  immediately 
above  and  to  the  left  of  this  number  is  the  superior  meatus.  6.  The  superior  turbinated  bone.  7.  The 
middle  turbinated  bone  j  the  numbers  5,  6,  7  are  situated  upon  the  internal  surface  of  the  left  lateral 
portion,  near  its  posterior  part.  8.  The  external  surface  of  the  lateral  part,  or  ps  planum.  9.  The 
superior  or  frontal  border  of  the  lateral  part,  marked  by  the  anterior  and  posterior  ethmoidal  cells. 
10.  Refers  to  the  concavity  of  the  middle  turbinated  bone,  which  is  the  upper  boundary  of  the  middle 
meatus  of  the  nose. 

cells,  which  are  completed  by  joining  their  congeners  in  the  margins  of 
the  orbitar  processes  of  the  os  frontis. 

The  vertical  process,  as  placed  below  the  cribriform  plate,  is  called 
nasal  lamella.  It  generally  divides  the  nostrils  equally,  but  is  occa- 
sionally inclined  to  one  side.  It  joins  below,  to  the  vomer  and  the  car- 
tilaginous septum  of  the  nose ;  its  front  is  in  contact  with  the  nasal 
spine  of  the  frontal  bone,  and  with  the  nasal  bones ;  and  behind,  with 
the  azygous  process,  or  rather  the  crista  of  the  sphenoid. 

Each  cellular  portion  of  the  ethmoid  forms,  by  its  exterior,  a  part 
of  the  orbit  of  the  eye,  which  surface  is  called  os  planum,  or  lamina 
papyracea.  The  internal  or  nasal  face  forms  part  of  the  nostril.  The  fore 
part  of  this  face  is  flat,  but,  posteriorly,  in  its  middle,  is  a  deep  sulcus, 
called  the  superior  meatus  of  the  nose.  The  upper  turbinated  bone 
(Concha  Morgagni),  a  small  scroll,  constitutes  the  upper  margin  of  this 
meatus.  The  inferior  internal  margin  of  the  cellular  portion  of  the 
ethmoid  is  formed  by  another  scroll  of  bone,  running  its  whole  length. 
This  is  the  middle  turbinated  bone  (Concha  media).  Moreover,  fro 
the  inferior  margin  of  the  cellular  portion,  one  or  more  laminae,  of 
irregular  form,  project  so  as  to  diminish  the  opening  into  the  upp 
maxillary  sinus. 

The  cells  in  the  ethmoid  bone  are  numerous  and  large,  the  posterior 

1  The  observations  of  Dr.  Leidy  go  to  prove  that  there  are  two  foramina  nearly  on  a  line, 
one  with  the  other,  at  the  front  of  the  cribriform  plate.  The  most  internal  one.  that  next 
to  the  crista  galli,  is  occupied  by  a  process  of  dura  muter,  and  the  most  external,  not  so  elon- 
gated in  its  shape  as  the  other,  transmits  the  internal  nasal  nerve. 


158  SKELETON. 

ones  (cellulds  palatinse)  discharge,  by  one  or  more  orifices,  into  the 
upper  meatus.  The  anterior  (cellulse  lachry males)  discharge  into  the 
middle  meatus  of  the  nose  by  several  orifices,  concealed  by  the  middle 
turbinated  bone.  The  most  anterior  of  these  cells  is  funnel-shaped 
(infundibulum),  and  joining  the  frontal  sinus,  conducts  the  discharge 
of  the  latter  into  the  nose. 

In  children  of  from  three  to  eight  years  of  age,  there  is  attached  to 
the  posterior  part  of  each  cellular  portion  of  the  ethmoid  a  triangular 
hollow  pyramid,  consisting  of  a  single  cell.  This  pyramid  arises,  not 
only  from  the  cellular  portion,  but  also  from  the  posterior  margin  of 
the  cribriform  plate,  and  of  the  nasal  lamella,  by  which  it  gains  a  large 
and  secure  base.  The  processus  azygos  of  the  sphenoid  bone  is  received 
between  the  two  pyramids.  In  the  base  of  the  pyramid,  communicat- 
ing with  the  nose,  is  a  foramen,  which  is  known  in  adult  life  as  the 
orifice  of  the  sphenoidal  sinus.  The  pyramid,  towards  puberty,  becomes 
a  part  of  the  sphenoidal  bone,  and  then  detaches  itself,  by  a  suture  at 
its  base,  from  the  ethmoidal.  As  life  advances  it  is  greatly  developed, 
no  indication  of  its  original  condition  remains,  and  it  becomes  fairly  the 
sphenoidal  cell ;  singularly  differing  in  shape  from  what  it  was  in  the 
beginning.1 

Having  been  put  upon  the  investigation  of  this  pyramid  by  Professor 
Wistar,  with  the  view  of  ascertaining  its  different  phases  of  develop- 
ment, it  has  occurred  to  me  to  see  it  in  every  stage,  from  that  of  a 
simple  triangular  lamina,  the  cornet  of  Bertin  ( Cornu  Bertini),  arising 
from  the  posterior  margin  of  the  cribriform  plate,  to  the  hollow 
pyramidal  state.  The  preceding  anatomists  described  it  but  imper- 
fectly ;  it  remained  for  that  distinguished  individual  to  elucidate  its 
real  history. 

Several  of  the  articulations  of  the  ethmoid  have  been  mentioned  ;  the 
remainder  will  be  introduced  with  the  bones  of  the  face. 


SECT.  III. — OF  THE  FACE. 

The  face  being  situated  at  the  inferior  anterior  part  of  the  base  of 
the  cranium,  is  bounded  above  by  this  cavity,  laterally  by  the  zygo- 
matic  arches  and  fossae,  and  posteriorly  by  the  space  occupied  by  the 
pharynx.  The  best  way  of  obtaining  precise  information  concerning 
its  form  and  composition  is  from  the  head  of  a  child,  of  from  five  to 

On  years,  in  which  the  bones  can   be   easily  parted.     In  the  adult, 
mewhat  advanced  in  life,  the  bones  cannot  be  separated  perfectly, 
Irom  their  being  united  more  or  less  together  by  the  obliteration  of 
their  sutures. 

The  face  is  composed  of  fourteen  bones,  thirteen  of  which  enter  into 
the  upper  jaw.  Twelve  of  the  thirteen  are  in  pairs :  they  are  the 
ossa  maxillaria  superiora,  ossa  malarum,  ossa  nasi,  ossa  ungues,  ossa 
turbinata  inferiora,  ossa  palati.  The  thirteenth  is  the  vomer.  A 


1  Wistar's  Anatomy,  vol.  i.  p.  31,  3d  edit. 


THE  FACE.  159 

single  bone,  with  corresponding  or  symmetrical  sides,  constitutes  the 
maxilla  inferior. 

1.  Superior  Maxillary  Bones  (Ossa  Maxillaria  Superior  a,  Maxillaires 

Superieurs}. 

These  may  be  known  by  their  superior  size,  and  by  their  composing 
almost  the  whole  front  of  the  upper  jaw.  They  are  too  peculiar  in 
their  figures  to  admit  of  comparison  with  any  common  object. 

The  superior  face  of  these  bones  is  formed  by  a  thin  triangular  plate, 
the  orbitar  process,  which  is  the  floor  of  the  orbit.  In  the  posterior 
part  of  this  plate  is  a  groove,  leading  to  a  canal  terminating  in  the 
front  of  the  bone,  at  a  foramen  called  infra-orbitar.  This  foramen  is 
situated  just  below  the  middle  of  the  lower  margin  of  the  orbit,  and 
gives  passage  to  the  infra-orbitar  nerve,  and  artery.  Externally, 
the  orbitar  plate  is  terminated  by  a  rough  unequal  triangular  surface, 
the  malar  process,  which  articulates  with  the  malar  bone. 

The  nasal  process  arises  by  a  thick,  strong  root,  from  the  front  upper^ 
part  of  the  bone  at  its  inner  side.  Its  front  edge  is  thin,  the  posterior 
margin  is  thicker,  and  the  upper  edge  is  short,  being  serrated  for  articu- 
lating with  the  os  fronds.  A  deficiency  exists  between  the  orbitar 

Fig.  38. 


An  external  view  of  the  Superior  Maxillary  of  the  left  side.— 1.  Orbitar  process.  2.  Infra-orbitar 
canal.  3.  Space  for  the  ps  unguis.  4.  Upper  part  of  the  lachrymal  gutter.  5.  Nasal  process,  and 
surface  for  articulating  with  theos  frontis.  6.  Surface  for  the  nasal  bone.  7.  Anterior  portion  of  the 
floor  of  the  nostril.  8.  Surface  for  articulating  with  its  fellow.  9.  Alveolar  processes.  10.  Depression 
just  below  the  infra-orbitar  foramen.  11.  Surface  for  the  malar  bone.  12.  Inferior  orbitar  foramen 

process  and  the  nasal  process,  for  accommodating  the  os  unguis,  and 
the  lachrymal  sac.     A  groove  (the  lachrymal  gutter),  leading   to  the 
nose,  is  formed  on  the  posterior  face  of  the  nasal  process,  and  mar" 
the  situation  and  extent  of  the  lachrymal  sac.     On  that  side  of  t 
root  of  the  nasal  process,  next  to  the  cavity  of  the  nose,  a  small  tran 
verse  ridge  is  seen  (Crista  turbinalis  inferior),  to  which  is  attached  the 
anterior  part  of  the  inferior  turbinated  bone. 

The  under  surface  of  the  os  maxillare  superius  is  marked  by  the 
alveolar  processes  for  lodging  the  teeth.  These  processes  are  broader 
behind  than  before,  corresponding  in  that  respect  with  the  teeth. 


160  SKELETON. 

Within  the  circle  of  the  alveoli  is  the  palate  process,  arising  from  the 
internal  face  of  the  body  of  the  bone.  The  palate  process  has  a  thick 
root,  is  thin  in  the  middle,  and,  where  it  joins  its  fellow,  has  its  margin 
turned  upwards  towards  the  nose  into  a  spine  or  ridge  (Crista  nasalis). 
The  anterior  end  of  the  nasal  crest  is  terminated  by  a  pointed  produc- 
tion of  bone,  the  anterior  nasal  spine  (Spin,  nasal.  anter.\  whereby 
its  articular  surface  is  increased.  It  presents  an  oblong  concave  sur- 
face above,  constituting  the  floor  of  the  nostril;  below,  it,  with  its 
fellow,  and  the  alveolar  processes,  form  one  concavity,  having  a  surface 
somewhat  rough,  which  is  the  roof  of  the  mouth.  The  palate  process 
does  not  extend  the  whole  length  of  the  superior  maxillary  bone,  but 
stops  half  an  inch  short  of  it,  posteriorly,  and  with  a  serrated  margin 
for  the  palate  bone.  When  the  two  maxillary  bones  are  in  contact,  we 
find  in  the  suture,  just  behind  the  front  alveolar  processes,  the  foramen 
incisivum,  which  bifurcates,  above,  into  each  nostril.  This  foramen 
contains  a  branch  of  the  spheno-palatine  nerve,  and  a  ganglion  formed 
from  it. 

In  front,  just  below  the  infra-orbitary  foramen,  the  bone  is  depressed, 
which  depression  is  filled  up  in  the  living  state  with  fat  and  muscles. 
But,  behind,  the  maxillary  bone  is  elevated  into  a  tuberosity,  between 
which  and  the  malar  process  is  a  broad  groove,  in  which  the  temporal 
muscle  plays. 

The  inner  face  of  the  upper  maxillary  bone  presents  a  view  of  the 
large  cavity  in  the  centre  of  it,  called  Antrum  Highmorianum.  The 
orifice  by  which  this  cavity  communicates  with  the  nose  is  much  di- 
minished by  the  palate  bone  behind,  the  ethmoid  above,  and  the  inferior  ' 
spongy  bone  below.  When  the  ahtrum  is  cut  open,  a  canal  is  seen  on 
its  posterior  part,  which  conducts  the  nerves  of  the  molar  teeth  to  their 
roots,  and  a  similar  canal  is  seen  in  front  of  the  antrum,  for  the  nerves 
of  the  front  teeth.  The  nerves,  in  both  instances,  come  from  the  infra- 
orbitary.  The  nerves,  till  they  begin  to  divide  into  filaments,  are 
between  the  lining  membrane  and  the  antrum,  but  afterwards  they 
make  complete  canals  in  the  alveolar  processes.  The  antrum  frequently 
communicates  with  the  frontal  sinus,  through  the  anterior  ethmoidal 
cells,  which  circumstance  is  omitted  by  most  anatomists. 

This  bone  is  articulated  with  the  frontal,  nasal,  unguiform,  malar, 
and  ethmoid,  above ;  to  the  palate  bone  behind ;  to  its  fellow,  and  to 
the  vomer,  at  its  middle ;  and  to  the  inferior  spongy  bone  by  its  nasal 
rface. 

the  earlier  periods  of  foetal  life  (from  the  fortieth  to  the  fiftieth 
there  is  found  at  the  anterior  part  of  the  palate  suture,  at  a  point 
ing  to  the  two  future  incisor  teeth  on  each  side,  a  distinct  piece 
of^Kfication  corresponding  with  the  Inter-maxillary  bones  of  animals, 
and  called  after  the  same  name  in  man.  In  cases  of  double  hare-lip, 
it  remains  permanently  distinct  from  the  upper  maxillary  bones,  and  is 
in  a  movable  state,  as  I  have  lately  found  in  a  child  two  and  a  half 
years  old,  upon  whom  I  operated.  Its  motion  could  be  readily  felt 
upon  the  anterior  part  of  the  vomer.  It  had  produced^  the  incisor 


THE  FACE.  161 

teeth,  which  were  extracted  twelve  or  eighteen  months  preparatory  to 
the  operation.  As  a  general  rule,  however,  the  only  trace  of  the  inter- 
maxillary bone  is  a  line,  sometimes  found  at  birth  extending  in  a  curved 
direction  from  the  incisive  foramen  to  the  alveolar  septum  .between  the 
outer  incisor  and  the  canine  tooth.  M.  J.  Weber  claims  to  have 
separated  the  intermaxillary  from  the  maxillary  in  infants  of  one  and 
two  years,  by  the  effect  of  acids.1  In  a  human  embryo  of  nearly  two 
inches  in  length,  and  presumed  to  be  from  sixty  to  seventy  days  old, 
Dr.  Leidy  found  these  intermaxillary  bones  to  be  one  and  two-thirds  of 
a  line  in  breadth,  and  one  line  in  height.2 

Fig.  39. 


a 


Fig.  39  represents  the  antero-inferior  surface  of  the  separate  Intermaxillary  Bone,  much  magnified, 
from  the  left  side,  but  reversed  by  the  camera,  a.  Ascending  or  nasal  process,  b.  Articulating  sur- 
face for  the  superior  maxillary  bone.  c.  Incisive  alveoli. 

2.  Palate  Bones  (Ossa  Palati,  Palatins). 

The  palate  bones,  two  in  number,  are  placed  at  the  back  part  of  the 
superior  maxillary,  between  them  and  the  pterygoid  processes  of  the 
sphenoid. 

For  descriptive  purposes  they  may  be  divided  into  three  portions — 
the  horizontal  or  palate  plate,  the  vertical  or  nasal  plate,  and  the 
orbitar  or  oblique  plate,  placed  at  the  upper  extremity  of  the  latter. 

The  palate  plate  is  in  the  same  line  with  the  palate  process  of  the 
superior  maxillary  bone,  and  supplies  the  deficiency  caused  by  its 
abrupt  termination.  It  is  square.  The  inferior  surface  is  flat,  but 
rough  for  the  attachment  of  -the  lining  membrane  of  the  mouth.  The 
superior  surface  is  concave,  and  forms  about  one-third  of  the  bottom  of 
the  nose.  The  anterior  margin  is  serrated  where  it  articulates  wit 
the  palate  process  of  the  maxillare  superius.  The  posterior  margin 
thin  and  crescentic.  The  internal  extremity  of  the  crescent  is  elona 
into  a  point  (spina  nasalis  posterior),  from  which  arises  the  azygos 
uvulae  muscle.  The  internal  margin  of  the  palate  plate  is  thick  and 
serrated  for  articulating  with  its  fellow,  the  upper  edge  of  it  (crista 
nasalis)  being  turned  upwards  to  join  the  vomer.  The  exterior  edge 

1  Bischoff,  Traite  de  Develop,  p.  393. 

2  Proceed.  Acad.  Nat.  Sc.  of  Philad.,  January,  1849. 
VOL.  I. — 11 


162 


SKELETON. 


touches  the  internal  side  of  the  maxillare  superius,  and  from  it  arises 
the  nasal  plate. 

The  nasal  plate  forms  the  posterior  external  part  of  the  nostril,  and 
is  much  thinner  than  the  palate  plate.  Its  side  next  the  nose  is 
slightly  concave,  and  is  divided  into  two  unequal  surfaces,  of  which  the 
lower  is  the  smaller,  by  a  transverse  ridge  (crista  turbinalis  inferior), 
that  receives  the  posterior  extremity  of  the  lower  turbinated  or  spongy 
bone.  The  external  face  is  in  contact  with  the  internal  face  of  the 
maxillary  bone,  and  presents  a  surface  corresponding  with  it.  The  nasal 
plate  of  the  palate  bone  diminishes  the  opening  into  the  Antrum  High- 
morianum  by  overlapping  it  behind.  Backwards  it  joins  the  pterygoid 
process  of  the  sphenoid  bone,  and  overlaps  its  anterior  internal  surface. 

At  the  inferior  and  posterior  part  of  the  nasal  plate,  where  the  cres- 
centic  edge  of  the  palate  plate  joins  it,  the  palate  bone  is  extended  into 
a  triangular  process,  called  the  pyramidal  (Processus  pyramidalis)  or 
pterygoid.  This  process,  on  its  posterior  surface,  presents  three 
grooves,  the  internal  of  which  receives  the  internal  pterygoid  process  of 
the  sphenoid  bone,  and  the  external  groove  receives  the  external  ptery- 
goid process  of  the  same  bone.  The  middle  fossa  has  its  surface  con- 
tinuous with  the  pterygoid  fossa  of  the  sphenoid  bone,  and  may  be  seen, 
in  the  articulated  head,  to  contribute  to  this  fossa.  The  anterior  surface 
of  the  pyramidal  process  of  the  palate  bone  presents  a  small  serrated 
tuberosity,  which  is  received  into  a  corresponding  concavity  on  the  pos- 
terior surface  of  the  maxillary  bone,  and  contributes  to  the  firmer  junc- 
tion of  the  two. 


Fig.  40. 


Right   Palate  Bone    seen 

from     behind.  —  1.     Palate 

plate.   2.  Nasal  plate.  .3, 10. 

.Pterygoid  process  with   its 

jlhree  grooves,  one  of  which 

is  in  the  middle.    4.  Crista 

Baaaiis  and  internal  surface 

^•fefe  plate.    5,11.  Pos- 

'         ijbiargin  of  palate  plate. 

6.    Crista     turbin.    inferior. 

,  Sphnni-palntine  notch  or 

foramen  below  which  is  seen 

the  sphenoidal  process.  8,9. 

Orbital  plate,  9  being  at  the 

ethmoidal  surface. 


On  the  external  surface  of  the  nasal  plate,  be- 
tween it  and  the  base  of  the  pyramidal  or  pterygoid 
process,  a  vertical  groove  is  formed,  which  is  con- 
verted into  a  complete  canal  by  the  maxillary 
bone.  The  lower  orifice  of  this  canal  is  near  the 
posterior  margin  of  the  palate.  It  is  called  the 
posterior  palatine  foramen,  and  transmits  the  pala- 
tine nerve  and  artery  to  the  soft  palate.  Imme- 
diately behind  this  canal  there  is,  not  unfrequently, 
a  smaller  one,  running  through  the  base  of  the 
pyramidal  process  of  the  palate  bone,  and  trans- 
mitting a  filament  of  the  same  nerve  to  the  palate. 


The  upper  extremity  of  the  nasal  plate  is  form- 
ed by  two  processes,  one  in  front  and  the  other 
behind,  separated  either  by  a  round  notch  or  a 
foramen.  The  posterior  of  the  two,  called  sphe- 
noidal process  (Processus  SpJienoidalis),  also 
pterygoid  apophysis,  is  inclined  over  towards  the 
cavity  of  the  nose.  It  is  thin,  and  fits  upon  the 
under  surface  of  the  body  of  the  sphenoid  bone, 
and  upon  the  inner  surface  of  the  internal  base  of  the  pterygoid  process 
of  the  same.  Its  upper  edge  touches  the  base  of  the  vomer.  The 
anterior  process  is  the  orbitar  portion  of  the  palate  bone. 


THE  FACE. 


163 


The  orbitar  portion  or  plate  is  longer  than  the  sphenoidal  process, 
and  is  hollow  and  very  irregular.  It  may  be  seen  in  the  posterior  part 
of  the  orbit  wedged  in  between  the  ethmoid  and  maxillary  bone.  The 
portion  of  it  which  is  there  found  is  the  orbital  face,  and  is  triangular. 
On  the  side  of  the  ethmoid  bone  its  cells  are  seen,  which  are  completed 
by  their  contiguity  to  the  ethmoid  and -sphenoid.  The  cells,  in  young 
subjects,  are  not  always  to  be  met  with.  The  posterior  face  of  the 
orbitar  portion  is  winding,  and  looks  towards  the  zygomatic  fossa. 

The  notch  between  the  orbitar  portion  and  the  pterygoid  or  sphe- 
noidal apophysis,  is  converted  into  a  foramen,  by  that  part  of  the  body 
of  the  sphenoid  bone  which  is  immediately  below  the  opening  of  the 
sphenoid  cell.  Through  this  foramen,  called  spheno-palatine,  pass  the 
lateral  nasal  nerve,  the  spheno-palatine  artery  and  vein. 

This  bone  can  scarcely  be  studied  advantageously  except  in  the 
separated  head.  A  single  application  of  it  to  the  maxillary  will  then 
show  how  it  extends  from  the  palate  of  the  mouth  to  the  orbit  of  the 
eye,  and  how  it  is  the  connecting  bone  between  the  maxillary  bone  and 
the  pterygoid  process  of  the  sphenoid. 

The  palate  bone  articulates  with  six  others.  With  the  upper  maxil- 
lary, the  sphenoid,  the  ethmoid,  the  inferior  spongy,  the  vomer,  and 
with  its  fellow.  The  places  of  junction  have  been  pointed  out  in  the 
description  of  the  bone. 


3.  Nasal  Bones  ( Ossa  Nasi,  Os  du  Nez). 

The  ossa  nasi,  two  in  number,  fill  up  the  vacancy  between  the  nasal  pro- 
cesses of  the  superior  maxillary  bones.  They  are  oblong  and  of  a  dense 
compact  structure,  being  so  applied  to  each  other  as  to  form  a  strong 
arch  called  the  bridge  of  the  nose,  which  is  farther  sustained  by  the 
nasal  spine  and  the  contiguous  oblique  serrated  surface  of  the  os  frontis. 

The  ossa  nasi  are  thick  and  serrated  at  their  upper  margins  ;  below, 
they  are  thin  and  irregular.  The  surfaces  by  which  they  unite  with 

Fig.  41. 


An  anterior  and  posterior  view  of  the  Left  Nasal  Bone.  Right-hand  figure. — Bone  seen  in  front. 
1.  Inferior  extremity.  2.  Articulating  surface  for  its  fellow.  3,4.  Margin  for  the  nasal  process  of  the 
superior  maxillary  bone.  5.  Articular  face  for  the  os  frontis.  6.  Foramen  for  a  nutritious  vessel. 
Lf.ft-hand  figure.— Bone  seen  from  behind  1.  Inferior  extremity.  2.  Surface  for  its  felloe.  3,4. 
Margin  for  ;he  superior  maxillary.  5.  Surface  fur  the  os  frontis  6.  Groove  for  the  internal  nasal 
nerve. 


164  SKELETON. 

each  other  are  broad,  comparatively  smooth,  with  the  exception  of  one 
or  two  small  serrated  processes,  and  have  their  edges  raised  into  a 
small  crest  (crista  nasalis),  where  they  join  the  nasal  lamella  of  the 
ethmoid  bone.  The  edge  by  which  they  join  the  nasal  process  of  the 
upper  maxillary  bone  is  curved ;  the  upper  part  of  this  edge  is  over- 
lapped by  the  nasal  process,  but  the  lower  part  of  it  overlaps  the  nasal 
process.  There  is  a  faint  serrated  arrangement  also  along  this  edge, 
to  afford  stronger  adhesion  to  the  nasal  process. 

On  the  posterior  face  of  the  os  nasi  is  to  be  seen  a  small  longitudinal 
groove,  formed  by  the  internal  nasal  branch  of  the  ophthalmic  nerve, 
which  nerve  occupies  the  foramen  orbitale  anterius  in  the  cribriform 
plate  of  the  ethmoid  bone. 

The  ossa  nasi  articulate  with  each  other  in  front,  with  the  nasal 
processes  of  the  upper  maxillary  behind,  with  the  septum  narium, 
where  they  are  in  contact  with  one  another,  and  with  the  os  frontis 
above. 

4.    Unguiform  Bones  ( Ossa  Ungues,  Os  Lacrymaux). 

The  unguiform  is   a  very  small  thin  bone,  apt  to  be  incompletely 
ossified,  so  that  it  puts  on  a  cribriform  condition ;  it 
Fig.  42.1  jg  placed  at  the  internal  side  of  the  orbit,  between 

the  nasal  process  of  the  upper  maxillary  and  the  os 
planum  of  the  ethmoid.  Its  orbitar  surface  is  divided 
into  a  face  which  is  in  a  line  with  that  of  the  os  pla- 
num, and  into  an  oblong  vertical  excavation,  the 
lachrymal  gutter,  continuous  with  the  concavity  on 
the  posterior  surface  of  the  nasal  process,  for  lodging 
the  lachrymal  sac.  These  surfaces  are  well  defined 
the  one  from  the  other  by  a  ridge,  sharp  and  elevated 
leff  side.— i.  supWior  below,  and  which  may  be  called  the  lachrymal  crest 

extremity.  2.  Fossa  for      /       .    ,        77  7.  \          -r,      •     /»  . 

the  lachrymal  sac.  s.  (crista  LadirymcLiis).  Its  interior  anterior  corner  is 
iirbuner  with  aonsd  pi!-  elongated  into  the  nose,  so  as  to  join  with  a  process 
num.  4.  inferior  extre.  Of  the  inferior  turbinated  bone,  whereby  the  ductus 
ad  nasum  is  rendered  a  complete  bony  canal. 

This  bone  lies  on  the  orbitar  side  of  the  most  anterior  ethmoid  cells, 
and  completes  them  in  that  direction, 

An  important  Variety  in  the  structure  of  this  part  of  the  orbit  occa- 
sionally occurs,  in  which  the  whole  fossa  for  lodging  the  lachrymal  sac 
is  formed  by  the  unusual  breadth  of  the  nasal  process  of  the  upper 
axillary  bone.  In  this  case,  the  only  part  of  the  os  unguis  which 
exists  is  that  in  the  same  plane  with  the  os  planum.  Several  examples 
have  come  under  my  own  notice.  Duverney  has  also  mentioned  it. 
>  aetimes  the  os  unguis  is  entirely  wanting,  in  which  case  the  os  pla- 
i  joins  the  nasal  process.2  A  variety  still  more  uncommon  is  men- 
tioned by  Verheyen,  where  the  lachrymal  fossa  is  formed  exclusively 
by  the  os  unguis. 

This  bone  articulates  very  loosely  with  the  adjoining  bones,  so  that 

1  The  reference  numbers  are  here  inverted. 

?  Berlin,  Traite  D'Qsteol,  vol.  ii.  p.  143,  Paris,  1754, 


THE  FACE.  165 

it  is  frequently  lost  from  the  skeleton.  It  joins  the  os  frontis  above, 
the  os  maxillare  superius  before  and  below,  the  os  planum  behind,  and 
the  inferior  spongy  bone  in  the  nose. 

5.   Cheek  Bones  ( Ossa  Malarum,  Jugalia,  Os  de  la  Pommette). 

These  bones,  two  in  number,  are  also  called  zygomatic  by  many  ana- 
tomists. They  are  situated  at  the  external  part  of  the  orbit  of  the  eye, 
and  form  the  middle  external  part  of  the  face. 

The  cheek  bone  is  quadrangular,  and  has  irregular  margins.  It  con- 
sists of  two  compact  tables,  with  but  little  intermediate  diploic  structure. 

There  are  three  surfaces  to  it.  That  which  contributes  to  the  orbit 
is  crescentic,  and  is  called  the  internal  orbitar  process.  The  exterior 
one  is  prominent,  and  forms  part  of  the  surface  of  the  face;  the  third 
surface  is  excavated,  and  forms  a  part  of  the  zygomatic  fossa.  Of  the 
four  margins,  two  are  superior,  and  two  inferior.  The  anterior  of  the 
first  two  is  concave,  and  rounded  off,  to  form  the  external  and  one-half 


An  anterior  view  of  the  Malar  Bone  of  the  right  side. — 1.  Inferior  orbitar  process.  2.  Internal 
orbitar  process.  3.  Superior  orbitar  process  for  articulating  -with  the  os  frontis.  4.  Zygomatic  pro- 
cess. 5.  Maxillary  process.  6.  Surface  for  the  superior  maxillary  bone.  7.  Nutritious  foramen. j 

of  the  lower  edge  of  the  orbit.     The  posterior  upper  border  above  is 
thin  and  irregular,  and  to  it  is  attached  the  temporal  fascia:  it  termi- 
nates behind  by  a  short  serrated  margin,  for  articulating  with  the  zygo- 
matic process  of  the  temporal  bone.     The  anterior  inferior  margin  is* 
serrated  its  whole  length,  for  articulating  with  the  superior  maxillary 
bone.     The  posterior  inferior  margin  gives  origin  to  part  of  the  ms 
seter  muscle.     Some  anatomists  admit,  also,  to  this  bone  a  fifth 
which  is  towards  the  bottom  of  the  orbit,  part  of  which  articuL 
with  the  great  wing  of  the  sphenoid  bone,  and  another  part 
•with  the  superior  maxillary.    Between  these  two  parts  is  a  nl 
ing  the  outer  extremity  of  the  spheno-maxillary  fissure. 

The  angles  of  this  bone  are  called  processes.  The  upper  ol 
is  continuous  with  the  external  angle  of  the  os  frontis,  is  the  superior 
orbitar,  or  angular  process.  The  orbitar  margin  terminates  below,  in 
the  inferior  orbitar,  or  angular  process.  That  portion  of  the  bone  which 
joins  with  the  zygoma  of  the  temporal  is  the  zygomatic  process;  and 


166  SKELETON. 

the  fourth  angle  is  the  maxillary  process,  in  continuation  with  which  is 
the  triangular  serrated  area,  for  union  with  the  upper  maxillary  bone. 

The  os  malae  articulates  with  four  bones;  to  wit,  with  the  maxillary, 
frontal,  sphenoidal,  and  temporal. 

There  are  some  few  small  foramina  in  this  bone,  which  transmit  nerves, 
being  filaments  from  the  first  and  second  branch  of  the  trigeminus;  and 
also  blood-vessels.  There  sometimes  exists  in  it  a  cavity  (the  sinus 
jugalis},  communicating  with  the  antrum  Highmorianum. 

6.  Inferior  Spongy  Bones  ( Ossa  Spongiosa  aut   Turbinata  Inferior^ 

Cornets  Infer ieurs}. 

This  pair  of  bones  is  situated  at  the  inferior  lateral  parts  of  the  nose, 
just  below  the  opening  into  the  antrum  Highmorianum.  They  are  very 
thin  and  porous,  and  their  substance  is  extremely  light  and  spongy. 

The  internal  face  of  the  spongy  bone  is  towards  the  septum  of  the 
nose,  and  is  an  oblong  rough  prominence.  The  external  face  is  a  cor- 
responding concavity  towards  the  maxillary  bone.  The  superior  margin 
presents,  in  front,  an  upright  process,  which  joins  with  the  anterior 
inferior  angle  of  the  unguiform  bone,  to  form  the  nasal  duct.-  Just 
behind  this,  the  margin  of  the  bone  is  turned  over  towards  the  antrum, 

Fig.  44. 


An  externnl  view  of  the  inferior  Spongy  Bone  of  the  right  side.— 1.  Anterior  extremity,  for  resting  on 
the  ridge  of  the  upper  maxillary.  42.  Posterior,  for  resting  on  the  ridge  of  the  palate  bone.  3.  Hooked 
portion,  for  resting  on  the  lower  margin  of  the  antrum  Highmorianum.  4.  Its  inferior  border. 

forming  a  broad  bend  or  hook,  which  rests  upon  the  lower  margin  of 
the  orifice  of  the  antrum,  and  diminishes  its  size.  From  the  superior 
margin,  also,  one  or  two  processes  not  unfrequently  arise,  whereby  this 
bone  joins  the  ethmoid.  The  inferior  margin  is  somewhat  thicker  than 
the  superior. 

The  anterior  extremity  of  this  bone  rests  upon  the  ridge  (crista  tur- 
nnalis)  across  the  root  of  the  nasal  process  of  the  upper   maxillary. 
^"      >osterior  extremity  rests,  in  like  manner,  upon  the  ridge  across  the 
of  the  palate  bone.1 

The  PUugJishare  ( Vomer). 

o  bone  is  placed  between  the  nostrils,  and  forms  a  consider- 
able part  of  their  septum.  It  is  frequently  more  inclined  to  one  side 
than  to  the  other.  It  is  formed  of  two  laminae,  between  which  there  is  a 
very  thin  diploic  structure. 

1  In  some  rare  cases  this  bone  adheres  to  the  ethmoid,  so  as  to  become  a  part  of  it. 


THE  FACE.  167 

The  sides  of  the  vomer  are  smooth  and  parallel.  It  has  four  mar- 
gins. The  superior  is  the  broadest,  and  has  a  furrow  in  it  for  receiving 
the  azygous  process  of  the  sphenoid  bone.  The  anterior  margin  being 
directed  obliquely  downwards  and  forwards,  its  front  part  joins  the 
cartilaginous  septum  of  the  nose,  and  the  posterior  part  receives,  in  a 
narrow  groove,  the  nasal  plate  of  the  ethmoid. 

Fig.  45.1 


The  Vomer. — 1.  Posterior  margin  terminating  the  septum  of  nose.  2.  The  superior  margin  hollowed 
to  receive  the  azygous  process  of  the  sphenoid  bone.  3.  Inferior  margin.  4.  Superior  margin  which 
joins  nasal  plate  of  ethmoid. 

The  posterior  margin  of  the  vomer  is  smooth  and  rounded,  making 
the  partition  of  the  nostrils  behind.  The  inferior  margin  articulates 
with  the  spine  or  ridge  (crista  nasalis)  of  the  superior  maxillary  and 
palate  bones,  which  exists  at  their  internal  border. 

Lower  Jaw  ( Os  Maxillare  Infer  ius,  Maxillaire  Infer ieur). 

This  bone  forms  the  lower  boundary  of  the  face,  and  is  the  only  one 
in  the  head  capable  of  motion.  In  early  life,  its  two  halves  are  sepa- 
rable, being  joined  at  the  middle  line  only  by  cartilage;  but,  in  the 
course  of  two  or  three  years  after  birth,  they  are  consolidated,  and  the 
original  cartilage  disappears. 

It  consists  of  a  body  or  region  which  corresponds  with  the  teeth,  and 
two  extremities  or  branches. 

The  inferior  part  of  the  body  presents  a  thick  and  rounded,  edge, 
which  is  the  base.     The  upper  part  of  the  body  is  formed  by  the 
alveolar  processes  for  receiving  the  teeth.     The  line  of  union  between 
the  halves,  being  called  the  symphysis,  is  marked  in  front  by  an  ele- 
vated ridge  (crista  or  spina  mentalis  externa],  terminated  below  by 
triangular  rising  of  the  anterior  mental  tubercle.     In  many  su 
this  tubercle  is  bounded  on  each  side  by  a  rounded  prominence  of 
which  gives  to  the  fore  part  of  the  jaw  an  unusual  squarenjM 
living  subject.     Just  above  the  latter  prominence,  there  isfl 
side,  a  transverse  depression,  from  which  arises  the  levator  fl^l 
the  lower  lip.     On  a  line  with  this  depression,  and  removed  a  liUPHs 
tance  from  its  external  extremity,  under  the  second  bicuspate  tooth  or 
the  interstice  between  it  and  the  first  large  molar  tooth,  is  the  anterior 
mental  or  maxillary  foramen,  the  termination  of  a  large  canal  in  either 
side  of  the  bone,  which  conducts  the  inferior  maxillary  blood-vessels 

1  Reference  numbers  inverted. 


168  SKELETON. 

and  nerve  to  the  teeth.  The  foramen  is  directed  obliquely  upwards  and 
backwards,  and  transmits  the  remains  of  these  blood-vessels  and  of  the 
nerve  to  the  face.  The  chin  is  that  part  of  the  bone  between  the  ante- 
rior mental  foramina.  As  the  alveolar  processes  do  not  exist  in  early 
life,  and  in  very  advanced  age  when  the  teeth  are  lost,  the  anterior 
mental  foramen  in  such  cases  is  very  near  the  superior  margin  of  the 
bone.  At  it  an  obtuse  ridge  of  bone  commences,  and  which  ends  in 
the  root  or  anterior  edge  of  the  coronoid  process.  The  alveolar  pro- 
cesses of  the  last  three  molar  teeth  are  placed  within  this  ridge,  and 
project  over  the  internal  face  of  the  bone. 

The  internal  or  posterior  face  of  the  lower  jaw  is  also  marked  at  the 
symphysis  by  a  ridge  (crista  or  spina  mentalis  internet)  passing  from 
the  superior  to  the  inferior  margin.  At  the  lower  part  of  this  ridge  is 
a  cleft  process,  sometimes  quadrate,  the  posterior  mental  tubercle,  for 
the  muscles  of  the  tongue.  Below  this  tubercle,  on  either  side,  is  a 
shallow  fossa,  for  receiving  the  digastric  muscle.  Between  the  lower 
margin  of  the  bone  and  the  protuberance  occasioned  by  the  alveolar 
processes  of  the  larger  molar  teeth,  is  an  oblong  large  fossa  made  for 
the  reception  of  the  submaxillary  gland;  a  small  horizontal  ridge  above 
it  marks  the  attachment  of  the  mylo-hyoid  muscle,  and  just  above  that 
there  is  another  depression  for  the  sublingual  gland. 

The  alveolar  processes  form  a  semicircle,  the  extremities  of  which 
are  carried  backwards  with  a  slight  divergence.  The  parietes  of  the 

Fig.  46. 


The  inferior  Maxillary  Bone.  1.  The  body.  2.  The  ramus.  3.  The  symphysis.  5.  Alveolar  pro- 
cesses. 5.  Bis-anterior  mental  foramen.  6,7.  Thebase.  8.  The  angle.  9.  Extremity  of  the  ridge  for  the 
mylo-hyoid  muscle.  10.  Coronoid  process.  11.  Condyle.  12.  Crescentic  edge  from  the  condyloid  to 
the  coronoid  process.  13.  Posterior  mental  foramen.  14.  Groove  for  the  mylo-hyoid  nerve.  15.  Mo- 
"  r  teeth.  16.  Points  to  bicuspate  teeth  of  right  side.  17.  Points  to  cuspate  tooth  of  right  side.  18.  In- 


•e  are  thin,  and  present  cutting  edges.     They  of  course  corre- 
^^number  and  shape,  with  the  roots  of  the  teeth  which  they 
^Bccommodate.     The  anterior  ones  are  deeper  than  the  poste- 
rior,  ms  a  general  rule,  the  alveolar  processes  may  be  said  to   come 
and  aepart  with  the  teeth ;  but,  when  a  single  tooth  is  extracted,  the 
alveolar  cavity  not  unfrequently  is  filled  up  with  osseous  matter,  the 
edge  of  it  alone  being  removed.     This  occurs  more  frequently  in  the 
lower  than  in  the  upper  jaw. 

The  base  of  the  lower  jaw  does  not  present  many  marks  worthy  of 


THE  FACE.  169 

attention.  It  should  be  observed  that  its  anterior  part  is  thicker 
than  the  posterior;  and  that  sometimes,  just  before  the  angle  of  the 
bone,  we  see  a  concave  curvature  of  this  edge,  but  generally  it  is 
straight,  or  nearly  so. 

The  extremities  or  rami  of  the  lower  jaw  are  quadrilateral,  and  rise 
up  much  above  the  level  of  the  body.  The  superior  margin  presents  a 
thin  concave  edge,  bounded  in  front  by  the  coronoid,  and  behind  by 
the  condyloid  process.  The  coronoid  process  is  triangular,  and  receives 
the  insertion  of  the  temporal  muscle ;  its  base  is  thick,  but  its  apex  is 
a  thin  rounded  point.  The  condyloid  process  is  a  transverse  cylindrical 
ridge,  directed  inwards,  with  a  slight  inclination  backwards,  its  middle 
being  somewhat  more  elevated  than  the  extremities.  It  springs  from 
the  ramus  by  a  narrow  neck.  There  is  a  concavity  at  the  inner  fore- 
part of  its  neck,  for  the  insertion  of  the  pterygoideus  externus,  and  a 
convexity  behind. 

The  external  face  of  the  ramus  is  flat,  but  marked  by  the  insertion 
of  the  masseter  muscle.  The  internal  face,  at  its  lower  part,  is  flat 
and  rough,  for  the  insertion  of  the  pterygoideus  internus.  At  the 
upper  part  of  this  roughness,  near  the  centre  of  the  ramus,  is  the  pos- 
terior mental  or  maxillary  foramen,  through  which  the  inferior  maxil- 
lary vessels  and  nerve  pass.  It  is  partially  concealed  by  a  spine  of 
bone,  into  which  the  spino-maxillary  ligament  from  the  os  sphenoides  is 
inserted.  Leading  from  this  foramen  is  a  small  superficial  groove, 
made  by  a  filament  of  the  inferior  maxillary  nerve. 

The  angle  of  the  inferior  maxillary  bone,  formed  by  the  meeting  of 
the  base  and  the  posterior  margin  of  the  ramus,  presents  diversities 
well  worth  attention,  at  different  epochs  of  life,  and  in  different  indi- 
viduals. In  very  early  life,  and  in  very  advanced,  when  the  alveoli 
are  absorbed,  it  is  remarkably  obtuse.  In  most  middle-aged  individuals 
it  is  nearly  rectangular.  Besides  which,  its  corner  is  sometimes  bent 
outwards  and  sometimes  inwards,  increasing  or  diminishing  thereby  the 
breadth  of  the  face  at  its  lower  part. 

The  substance  of  this  bone,  externally,  is  hard  and  compact.  In- 
ternally there  is  a  cellular  structure,  through  the  centre  of  which  runs 
the  canal  for  the  nerves  and  blood-vessels.  From  this  canal  smaller 
ones  are  detached,  containing  the  vascular  and  nervous  filaments  which 
go  to  the  roots  of  the  teeth.  The  condyles,  or  condyloid  processes  of 
the  os  maxillare  inferius,  articulate  with  the  temporal  bones  by  means 
of  their  glenoid  cavities. 

Remarks. — The  os  maxillare  inferius  has  a  greater  influence  o 
form  of  the  face  than  any  other  bone  entering  into  its  com 
Sometimes  it  is  much  smaller  in  proportion  in  certain  indivicn.s  th 
in  others.  Sometimes  its  sides,  being  widely  separated,  cauaB 
shortening  to  the  chin,  and  breadth  to  the  lower  hind  part  ofHrface. 
In  many,  instances,  the  alveolar  processes,  in  front,  incline  obliquely 
over  the  outer  circumference  of  the  bone,  and  thereby  give  to  the  chin 
the  appearance  of  receding  considerably.  In  others,  the  alveoli  incline 
over  the  inner  circumference,  which  causes  the  chin  to  project  un- 
usually. 


170  SKELETON. 


CHAPTER  III. 
GENERAL  CONSIDERATIONS  ON  THE  HEAD. 

HAVING  described  the  individual  bones  of  the  head,  it  will  now  be 
proper  to  consider  it  as  a  whole. 

SECT.    I. — OF   THE   DIPLOIC   STRUCTURE   OF   THE   CRANIUM. 

The  bones  of  the  cranium,  in  the  adult,  consist  of  an  external  and  of 
an  internal  table  ;  united  by  a  bony  reticulated  or  cellular  substance, 
which  does  not  manifest  itself  very  distinctly  till  two,  three,  or  even 
more  years  are  passed  by  the  infant.  The  internal  table  of  the  skull 
is  thinner  and  more  brittle  than  the  external,  and  has  obtained,  from 
that  cause,  the  name  of  vitreous  table.  In  the  male  adult,  the  flat  bones 
of  the  cranium  where  they  are  much  exposed,  as  above  the  parietal 
ridge  and  in  front  and  behind,  are  about  three  lines  in  thickness,  on  an 
average ;  but  there  are  individual  peculiarities  departing  much  from 
this  rule,  reducing  it  to  one-half  or  more  than  doubling  it,  besides 
making  the  thickness  very  unequal. 

The  cells  of  the  diploic  structure  are  not  to  be  confounded  with  the 
large  sinuses  already  described,  that  exist  in  the  frontal,  the  temporal, 
and  the  sphenoidal  bones.  They  are  formed  under  different  circum- 
stances, and  do  not  communicate  with  them.  The  sinuses  are  lined  by 
a  mucoois  membrane,  whereas  the  lining  membrane  of  the  cells  of  the 
diploe  corresponds  with  the  endosteum  or  internal  periosteum  of 
other  bones.  I  have  a  preparation,  in  which  a  diploic  structure  of  the 
os  frontis  exists  between  its  sinuses  and  the  external  table  of  the  bone  : 
in  the  same  head,  a  similar  circumstance  existed  in  regard  to  the  tem- 
poral bone  ;  from  which  we  infer  that  the  diploic  structure,  in  these 
places,  is  caused  to  recede,  and  even  to  be  partially  obliterated,  when 
the  development  of  the  sinus  commences,  which  is  not  until  some  time 
after  the  evolution  of  the  diploic  structure.  The  sphenoidal  bone, 
when  fully  evolved  in  its  body,  is  a  remarkable  instance  of  the  reces- 

ion  of  diploic  structure  for  the  purpose  of  forming  a  sinus, 
^the  diploe  of  the  dried  bones,  several  arborescent  channels  may 
be  sej^by  the  removal  of  the  external  table.1  They  were  discovered 
about  the  year  1805,  by  M.  Fleury,  while  he  was  Prosector  at  the 
hool  of  Medicine  in  Paris :  and  engaged,  at  the  instigation  of  M. 
at^Rr,  in  some  inquiries  relative  to  the  structure  of  the  cranium. 
The  account  given  by  the  latter  is,  that  these  channels  are  occupied  in 
the  recent  subject,  by  veins,  which,  like  all  others,  are  intended  to 
return  the  blood  to  the  heart.  These  veins  are  furnished  with  small 

1  Chaussier,  Exposition  de  la  Structure  de  1'Encephale,  Paris,  1807. 


THE  SUTURES.  171 

valves,  have  extremely  thin  and  delicate  parietes,  and  commence  by 
capillary  ramifications,  coming  from  the  different  points  of  the  vascular 
membrane,  which  lines  the  cells  of  the  diploe.  Their  roots  are  at  first 


A  view  of  the  Skull  deprived  of  its  outer  table,  so  as  to  shovy  the  diploic  structure.    The  arborescent 
dark  lines  indicate  the  channels  for  the  diploic  sinuses  or  veins. 

extremely  fine  and  numerous,  form  by  their  frequent  anastomoses  a 
kind  of  net- work,  and  produce  by  their  successive  junction,  ramuscles, 
branches,  and  large  trunks,  which,  becoming  still  more  voluminous,  are 
directed  towards  the  base  of  the  cranium.  Some  variations  exist  in 
regard  to  the  number,  size,  and  disposition  of  these  trunks ;  but  gene- 
rally, one  or  two  of  them  are  found  on  either  side  of  the  frontal  bone, 
two  in  the  parietal  bone,  and  one  on  either  side  of  the  occipital  bone. 
Anastomoses  exist  between  these  several  trunks,  by  which  the  veins  in 
the  parietal  bone  are  joined  to  those  in  the  frontal  and  in  the  occi- 
pital. Branches  from  the  right  side  of  the  head  also  anastomose  with 
those  from  the  left  side.  Besides  the  branches  already  mentioned,  one 
or  two,  smaller  than  the  others,  are  directed  towards  the  top  of  the 
head,  and  terminate  in  the  longitudinal  sinus. 

The  descending  veins  of  the  diploe  communicate  in  their  passage 
with  the  contiguous  superficial  veins,  and  empty  into  them  the  blood 
which  they  receive  from  the  several  points  of  the  diploe.  These  com- 
munications are  passed  through  small  foramina,  which  penetrate  from 
the  surface  of  the  bone  to  the  diploe.  The  trunks  of  such  diploic  veins 
as  are  continued  to  the  base  of  the  cranium  open  partly  into  the  sinuses 
of  the  dura  mater,  and  partly  into  the  venous  plexus  at  the  base  of  the 
pterygoid  apophyses  of  the  sphenoid  bone,  and  form  there  the  venoj 
communications  through  the  foramina  of  the  base  of  the  cranium 
called  the  emissaries  of  Santorini.  Moreover,  there  are  communica- 
tions sent  from  the  diploic  veins,  through  the  porosities  of  the^^BSI 
table  of  the  skull,  to  the  veins  of  the  dura  mater.  This  fact  is  i^JPered 
very  evident  by  tearing  off  the  skull-cap,  when  the  surface  of  the  dura 
mater  will  be  studded  with  dots  of  blood,  and  the  internal  face  of  the 
bone  also,  particularly  in  apoplectic  subjects.  It  appears,  indeed,  that 
the  arteries  of  the  cranium  are  principally  distributed  on  its  external 
surface,  and  the  veins  on  its  internal  surface  and  diploe. 


172  SKELETON. 

In  the  infant,  the  diploic  veins  are  small,  straight,  and  have  but  few 
branches:  in  the  adult,  they  correspond  with  the  description  just  given, 
and,  in  old  age,  they  are  still  more  considerable,  forming  nodes  and 
seeming  varicose.  In  children,  when  the  bones  are  diseased,  they  par- 
take of  the  latter  character.  In  order  to  see  them  fully,  the  external 
table  of  the  skull  must  be  removed,  both  from  its  vault  and  base,  with 
a  chisel  and  mallet.  This  operation  will  be  much  facilitated  by  soaking 
the  head  previously  in  water  for  two  days. 

The  diploic  sinuses,  as  well  as  the  corresponding  channels  in  the 
bodies  of  the  vertebrae,  are  now  considered  as  an  enlarged  condition  of 
Haversian  canals. 


SECT.  II. — OF  THE  SUTURES. 

Except  in  advanced  age,  the  bones  of  the  cranium  and  of  the  face 
are  very  distinctly  limited,  but  also  united  by  sutures. 

The  latter  are  formed  by  the  proximate  edges  of  the  contiguous 
bones  presenting  a  multitude  of  sharp  serrated  points,  and  of  deep 
narrow  pits,  by  which  they  interlock  by  an  accurate  and  firm  contact. 
Here  and  there,  in  the  sutures  which  unite  the  flat  bones  of  the  cranium, 
we  find  not  only  sharp  points,  but  complete  dove-tail  processes  of  the 
one  bone  received  into  corresponding  cavities  of  the  other.  The  den- 
ticulation  of  the  sutures  is  much  more  common,  and  much  better 
marked,  on  the  external  than  on  the  internal  surface  of  the  cranium. 
On  the  latter,  the  union  of  the  bones  is,  in  several  instances,  in  a  line 
nearly  straight ;  in  which  case,  the  denticulation  is  almost  exclusively 
confined  to  the  external  table  and  to  the  diploic  structure. 

The  Coronal  Suture  (Sutura  Coronalis),  so  named  from  its  corre- 
sponding in  situation  with  the  garlands  worn  by  the  ancients,  begins 
at  the  sphenoid  bone,  about  an  inch  and  a  quarter  behind  the  external 

Fig.  48. 


A  view  of  the  outside  of  the  Vault  of  the  Cranium,  showing  the  Sutures.— 1.  The  coronal  suture. 
•2.  The  sagittal  suture.    3.  The  lambdoidal  suture. 


THE  SUTURES.  173 

angular  process  of  the  os  frontis.  It  inclines  so  much  backwards  in 
its  ascent,  that  when  we  stand  erect,  with  the  head  in  its  easiest  posi- 
tion, a  vertical  line,  dropped  from  its  point  of  union  with  the  sagittal 
suture,  would  pass  through  the  centre  of  the  base  of  the  cranium,  and 
would  cut  another  line  drawn  from  one  meatus  auditorius  externus  to 
the  other.  It  unites  the  frontal  bone  to  the  two  parietal. 

The  Sagittal  Suture  (Sutura  Sagittalis)  unites  the  upper  margins  of 
the  two  parietal  bones,  and  is  immediately  over  the  division  between 
the  hemispheres  of  the  cerebrum.  It  has  been  stated,  in  the  account 
of  the  os  frontis,  that  sometimes  it  is  continued  through  the  middle  of 
this  bone  down  to  the  root  of  the  nose. 

The  Lambdoidal  Suture  (Sutura  Lambda-formic]  is  named  from 
its  resemblance  to  the  Greek  letter  lambda,  and  consists  of  two  long 
legs  united  angularly.  It  begins  at  the  posterior  termination  of  the 

Fig.  49. 


A  posterior  and  inferior  view  of  the  Head.— 1.  The  middle  palate  suture.    2.  Posterior  end  of  th« 
sagittal.    3.  The  lambdoidal.    4.  Os  Wormianum. 

sagittal  suture,  and  continues  down  to  the  base  of  the  cranium,  as  far 
as  the  jugular  eminences  of  the  occipital  bone.  Its  upper  half  unites 
the  occipital  to  the  parietal  bones,  and  the  lower  half  the  occipital  to 
the  temporal  bones.  The  latter  half  is  sometimes  called  the  Addita- 
mentum  Suturoe  Lambdoidis. 


The  Squamous  Suture  (Sutura  Squamosa)  is  placed  on 
the  head,  and  unites  the  parietal  to  the  temporal  bone. 
semicircular  edge  of  the  latter  overlaps  the  concave  edge  of  i  for' 
mer.  It  differs  from  other  sutures  by  the  defect  of  serrated  mwgins, 
and  by  the  edge  of  one  bone  reposing  upon  the  edge  of  the  other.  The 
squamous  suture  is  converted  into  the  common  serrated  one,  where  the 
upper  edge  of  the  angle  of  the  temporal  bone  joins  the  parietal.  This 
portion  is  called  the  Additamentum  Suturse  Squamosae. 


174  SKELETON. 

The  squamous  mode  of  suture  unites,  likewise,  the  great  wing  of  the 
sphenoidal  to  the  temporal  angle  of  the  parietal. 

In  the  upper  part  of  the  lambdoidal  suture,  particularly,  we  find  in 
many  skulls  one  or  more  small  bones,  connected  to  the  parietal  and 
occipital  bones  by  serrated  margins.  They  are  called  the  Ossa  Worm- 
iana  or  Triquetra.  They  vary  very  much  in  their  magnitude,  being  in 
different  subjects  from  a  line  to  one  inch,  or  an  inch  and  a-half  in 
diameter.  I  have  seen  them  of  the  latter  size,  and  even  larger,  occu- 
pying entirely  the  place  of  the  superior  angle  of  the  os  occipitis. 
Most  commonly,  but  not  always,  when  one  of  these  bones  exists  on 
one  side  of  the  body,  a  corresponding  one  exists  on  the  other.  A  con- 
geries of  these  bones,  united  successively,  is  sometimes  found  in  the 
lambdoidal  suture;  in  such  cases  they  are,  for  the  most  part,  small. 
Commonly  these  bones  consist,  like  the  other  bones  of  the  cranium,  of 
two  tables  and  an  intermediate  diploe,  and  form  an  integral  portion 
of  the  thickness  of  the  cranium ;  sometimes,  however,  they  compose 
only  the  external  table.  M.  Bertin  says,  that  he  has  seen  them,  also, 
composing  only  the  internal  table  of  the  cranium. 

All  the  sutures  mentioned  besides  the  lambdoid,  may  exhibit,  at  any 
of  their  points,  the  Ossa  Triquetra  or  Wormiana.  We  have  examples 
of  them  in  the  coronal,  the  sagittal,  and  the  squamous,  but  in  such 
cases  they  are  small.  The  lambdoid  unquestionably  has  them  most 
frequently.  M.  Bertin  has  seen  a  large  square  bone  at  the  fore  part 
of  the  sagittal  suture,  occupying  the  place,  and  presenting  the  form,  of 
what  was  once  the  anterior  fontanel :  he  has  also  seen  triquetral  bones 
in  the  articulations  of  the  bones  of  the  face.1 

The  sutures  described  belong  exclusively  to  the  cranium,  but  there 
are  others  common  to  it  and  to  the  face.  The  sphenoidal  suture  sur- 
rounds the  bone  from  which  its  name  comes;  the  ethmoidal  suture 
surrounds  the  ethmoidal  bone;  the  zygomatic  suture  unites  the  tem- 
poral and  malar  bones;  the  transverse  suture  runs  across  the  root  of 
the  nose,  and  also  unites  the  malar  bones  to  the  os  frontis.  The  mid 
die  palate  suture  unites  the  palatine  processes  of  the  palate  and  of  the 
upper  maxillary  bones  respectively;  the  transverse  palate  suture  crosses 
the  hard  palate.  In  the  same  way  the  other  articular  lines  of  the  face 
derive  their  names  from  the  bones  they  unite,  and  do  not  merit  a  par- 
ticular attention  at  this  time,  as  enough  has  been  said  in  the  descrip- 
tion of  the  bones  themselves. 

The  base  of  the  cranium  is  remarkably  different,  in  the  manner  of 

tits  articulations,  from  the  upper  part.     The  surface,  in  the  first  place, 

is  very  rugged,  and  much  diversified  by  its  connection  with  muscles  and 

Ibones  :  besides  which,  there  is  a  considerable  number  of  large  foramina 

*and  fissures  in  it  for  the  blood-vessels  and  nerves.     To  guard  against 

the  weakness  arising  from  the  latter  arrangement,  nature  has  given  a 

very  increased  thickness  to  the  base,  particularly  where  much  pressure 

from  the  weight  of  the  head  exists,  and  has  applied  unusually  broad 

surfaces  of  bone  to  each  other  to  secure  them  from  displacement  by 

1  Berlin,  Trait£  d'Osteol. 


THE  SUTURES.  175 

concussion,  and  different  kinds  of  violence.  These  arrangements  are 
particularly  manifest  at  the  junction  of  the  cuneiform  process  of  the 
occipital  bone  with  the  body  of  the  sphenoid,  which,  in  middle  age,  or 
rather  shortly  after  puberty,  is,  as  stated  before,  anchylosed  or  synos- 
tosed,  at  the  lower  part  of  the  lambdoidal  suture,  and  at  the  margins 
of  the  petrous  portion  of  the  temporal  bones  where  they  touch  the  con- 
tiguous bones.  Hence  it  results,  that  the  several  fastenings  of  the 
base  of  the  cranium,  and  also  of  the  upper  maxilla,  are  so  complete 
and  strong,  that  they  are  most  generally  perfectly  exempt  from  dislo- 
cation, and  when  the  violence  offered  to  them  is  sufficiently  great,  the 
bones,  in  place  thereof,  are  fractured. 

The  use  of  the  sutures,  in  the  cranium  and  upper  maxilla,  is  some- 
what problematical  ;  for  as  none  of  the  bones  move,  the  head  might 
have  been  equally  well  arranged  by  being  made  of  a  single  piece.  In 
proof  of  which  it  is  only  necessary  to  recollect,  that  in  the  very  aged 
there  is  frequently  not  a  bone  of  the  cranium  and  upper  maxilla  to  be 
found  in  an  insulated  state  :  they  are  all  blended  with  the  adjoining 
bones,  by  the  obliteration  of  their  sutures.  The  old  notion  that  sutures 
existed  for  the  purpose  of  arresting  the  course  of  fractures,  and  for 
opening  in  some  diseased  conditions  of  the  brain,  has  been  very  justly 
exploded.  We  know  that  a  fracture  will  traverse  a  suture  readily, 
and  that  the  opening  of  the  sutures  from  hydrocephalus  is  an  occur- 
rence only  of  very  early  infancy,  where  the  sutures  have  not  arrived  at 
the  serrated  and  dove-tail  arrangement  by  which  they  are  subsequently 
secured.  It  is  much  more  probable  that  the  true  ground  for  the  exist- 
ence of  sutures  is  found  among  the  laws  peculiar  to  the  growing  state, 
and  which  most  commonly  are  suspended  after  the  several  developments 
have  been  accomplished.  Thus,  the  head,  in  consequence  of  being 
separated  by  sutures  into  many  pieces,  is  more  readily  wrought,  from 
its  form  and  size  in  the  embryo  state,  to  the  form  and  size  required  by 
adult  life.  This  necessity  of  subdivision  into  many  pieces  does  not 
depend  so  much  on  the  size,  as  on  the  shape  of  the  head,  for  we  find 
the  larger  animals,  as  the  elephant,  having  no  more  sutures  than  the 
smaller.  This  opinion  is  also  sustained  by  what  we  see  in  other  bones, 
bones  of  a  very  simple  shape,  as  those  of  the  tarsus  and  carpus,  consist- 
ing from  the  very  beginning  of  but  one  piece.  But  where  the  shape  of 
a  bone  is  complicated,  we  find  it,  while  growing,  submitted  to  the  same 
law  as  the  head  at  large,  and  consisting  of  many  pieces.  In  such  cases 
these  pieces  are  united  by  a  species  of  suture  corresponding  precisely 
with  the  form  of  suture  observed  between  some  of  the  bones  of  the 
cranium  (as,  for  example,  between  the  occipital  and  the  sphenoid)  ;^ 
thus,  the  os  femoris,  till  adult  age,  consists  of  five  pieces,  its  two* 
articular  extremities,  its  body,  its  trochanter  major,  and  its  trocjj|nter« 
minor.  The  cranium  itself,  before  birth,  and  for  some  time  aftSR  has^i 
several  of  its  individual  bones  consisting  each  of  two,  or  more  pieces; 
which  favors  still  more  the  idea. 

Some  persons  think  that  the  sutures  of  the  adult  are  only  remains 
of  an  arrangement  intended  exclusively  for  the  benefit  of  the  parturient 
state,  by  maintaining  a  plasticity  of  the  head  of  the  foetus,  which 
admits  of  its  diameters  accommodating  themselves  to  the  diameters  of 


176  SKELETON. 

the  pelvis  of  the  mother.  This  theory  is  rather  too  exclusive,  though 
it  may  be  admitted  that  the  sutures  in  a  foetal  head  have  that  use,  and 
are  in  some  cases  of  parturition  a  most  fortunate  coincidence,  by  which 
the  lives  of  both  parties  are  saved.  But  it  should  be  observed  that  in 
a  great  number  of  cases,  the  head  of  the  foetus  never  changes  its  form 
in  passing  through  the  pelvis,  because  the  passage  is  quite  large  enough 
without  it ;  and,  again,  if  the  sutures  were  intended  expressly  for  the 
parturient  state,  we  ought  not  to  find  them  in  birds,  and  in  such 
animals  as  are  hatched,  because  the  necessity  for  them  there  does  not 
exist.1 

Upon  the  whole  we  may  safely  conclude,  that  the  sutures  of  the 
cranium  and  face  are  simply  a  provision  for  the  growing  state,  and 
that,  like  all  other  provisions  for  this  state,  it  also  ceases  at  its  appro- 
priate period,  and  sometimes  leaves  not  a  vestige  of  its  existence. 
Occasionally,  indeed,  we  find  the  latter  to  have  occurred  in  one  or  more 
sutures,  even  before  the  age  of  puberty,  as  I  have  repeatedly  witnessed 
in  the  sagittal,  the  squamous,  and  the  lambdoidal  sutures. 

The  manner  in  which  the  sutures  are  formed  is  sufficiently  interest- 
ing :  they  are  generally  said  to  be  made  by  the  radii  of  ossification, 
from  the  opposite  bones  meeting  and  passing  each  other,  so  as  to  pro- 
duce a  serrated  edge.  This  explanation  may  account  partially  for  the 
shape  of  the  edge  of  the  sutures,  but  not  for  their  uniform  position;  inas- 
much as  we  nearly  always  find  the  sutures  in  the  same  relative  situa- 
tion, and  having  the  same  course.  If  they  depended  exclusively  on  so 
mechanical  a  process,  as  the  rays  of  one  bone  shooting  across  the  rays 
of  another  by  their  own  force,  we  ought  to  see,  more  frequently,  the 
sagittal  suture  more  on  one  side  of  the  head  than  on  the  other,  and 
not  straight,  because  in  some  instances  ossification  is  a  more  rapid  pro- 
cess on  one  side  than  on  the  other.  Moreover,  in  all  cases  where  bones 
arise  from  different  points  of  ossification,  and  meet,  the  serrated  edge 
should  be  formed,  and  particularly  in  the  flat  bones.  Observation, 
however,  proves  that  the  os  occipitis,  which  is  formed  originally  from 
four  points  of  ossification,  and  therefore  has  as  many  bones  composing 
it  in  early  life,  does  not  present  these  bones  afterwards  united  by  the 
serrated  edge.  The  acromion  process  of  the  scapula,  though  origin- 
ally distinct  from  the  spinous,  never  unites  to  it  by  suture,  but  always 
by  synostosis.  The  mode  of  junction  in  the  three  bones  of  the  sternum 
is  always  by  synostosis.  In  short,  the  observation  holds  good  in  nume- 
rous other  instances. 

Bertin  and  Bichat  reject  fully  the  mechanical  doctrine  concerning 
the  sutures,  and  present  one  founded  upon  reason  and  observation,  and 

usceptible  of  confirmation  by  any  accurate  observer.     The  dura  mater 
d  the  pericranium,  before  calcification  commences,  form  one  mem- 

rane  consisting  of  two  laminae.  Partitions  pass  from  one  of  these 
laminae  to  the  other,  which  mark  off  the  shape,  or  constitute  the  mould 
of  the  bones  long  before  they  are  perfected.  The  peculiar  shape  of 

1  A  gentleman  whose  anatomical  writings  have  some  vogue  in  this  country,  has  cut  the 
Gordian  knot,  by  telling  us  that  they  are  "  accidental  merely,  and  of  little  use!!" — Ariat.  of  the 
Human  Body,  by  John  Bell,  Surgeon,  Edinburgh. 


STRUCTURE  OF  THE  CRANIUM.  177 

the  bony  junction,  or,  in  other  words,  of  the  sutures  or  edges  of  the 
bones  in  adult  life,  depends,  therefore,  exclusively  upon  the  original 
shape  of  the  partitions.  When  the  latter  are  serrated,  the  points  of 
ossification  will  fill  up  these  seme;  but  when  they  are  oblique,  the 
squamous  suture  will  be  subsequently  formed. 

This  theory  also  accounts  for  modes  of  junction  intermediate  to  the 
squamous  and  serrated  suture  ;  for  the  formation  of  the  Ossa  Triquetra 
or  Wormiana ;  for  their  existence,  form,  size  and  number,  in  some 
skulls,  and  their  total  absence  in  others.  The  inference  will  also  be 
obvious,  that  in  all  ossifications  from  different  nuclei,  a  suture  will  not 
be  formed,  where  the  membranous  partitions  do  not  exist ;  but  that 
the  bones  will  unite  after  the  manner  of  such  as  are  fractured.  We 
shall  also  understand,  that  when  these  partitions  are  weak  and  imper- 
fect, either  from  their  congenital  condition,  or  from  advanced  age,  as 
happens  in  all  sutures,  but  with  some  differences  of  time,  the  bones  of 
the  opposite  sides  are  blended  together  completely. 

The  partitions  which  determine  the  places  of  the  sutures  may  be 
demonstrated  in  a  young  adult  skull  by  removing  with  muriatic  acid 
the  calcareous  portion  of  the  bones,  so  as  to  leave  only  the  animal  part. 
On  opening  the  suture  after  this  process,  it  will  be  seen,  that  the  peri- 
cranium sends  in  its  partition,  which  is  met  by  the  partition  coming 
from  the  dura  mater.  Or,  if  either  of  these  membranes  be  peeled  off, 
its  contribution  of  partition  will  appear  very  plainly  projecting  from 
its  surface,  in  the  form  of  a  ridge. 

Owing  to  congenital  hydrocephalus,  the  sutures  of  the  vault  of  the 
cranium  have  been  known  to  remain  open  for  years  after  birth,  from  the 
continued  augmentation  of  the  volume  of  the  brain.  In  such  cases 
additional  bones  are  sometimes  formed,  manifesting  a  strong  attempt, 
on  the  part  of  nature,  to  cover  the  brain  with  bone.  I  obtained,  seve- 
ral years  ago,  a  specimen  of  this  kind  belonging  to  a  foetus  of  nine 
months,  whose  head  was  as  large  as  it  is  commonly  in  adult  life,  and 
in  whom  there  were  two  ossa  parietalia  on  one  side.  Morgagni,*  whose  au- 
thority is  proverbial  in  mor bid  anatomy,  states,  that  a  learned  colleague 
and  intimate  friend  of  his,  Bernardin  Kammazzini,  aged  seventy,  had  the 
sutures  open  at  that  period  of  life.  He  does  not  say  at  what  time  this 
condition  of  them  appeared.  I  think  it  more  probable  that  they  had 
never  been  closed,  though  Morgagni  leaves  the  reader  to  infer  that  it 
was  a  circumstance  which  had  arisen  from  a  violent  hemicrania  with 
which  the  patient  had  been  seized  when  he  was  advanced  in  life.  Diemer- 
broeck  found,  in  a  woman  of  forty,  the  anterior  fontanel  not  ossified. 
Bauhius'  wife,  aged  twenty-six,  had  the  sutures  not  yet  closed.  In- 
deed, there  is  no  deficiency  of  well-authenticated  similar  instances 
more  of  which  it  will  be  unnecessary  to  adduce.  It  may  be  observe 
here,  that  when  from  congenital  hydrocephalus,  attended  with  much 
extension  of  the  brain,  the  bones  of  the  cranium  are  compelled  to 
grow  beyond  their  usual  diameters,  they  are  uncommonly  thin,  and  the 
diploic  structure  is  very  imperfectly  developed  ;  which  will  account  for 
their  separation  at  any  period  of  life,  from  the  fastening  being  so 
slight. 

*  Causes  and  Seats  of  Disease,  Letter  3d,  Art.  8th. 
VOL.  I.— 12 


178  SKELETON. 


SECT.  III.— THE  INTERNAL  SURFACE  OF  THE  CRANIUM. 

The  points  for  study  in  viewing  the  cranium  as  a  whole  are  generally 
the  same  as  have  been  presented  in  the  detail  of  each  bone.  It  is, 
nevertheless,  useful  to  regard  the  structure  in  its  connected  state,  as 
new  views  are  thus  presented  of  the  relative  situation  of  parts,  and  of 
the  formation  of  the  several  fossae  and  cavities. 

The  interior  of  the  cranium,  or  the  cavity  for  containing  the  brain,  is 
regularly  concave  above,  and  is  there  called  the  arch  or  vault;  but 
below,  it  is  divided  into  several  fossae,  and  is  called  the  base. 

The  whole  cavity  is  lined  by  the  dura  mater,  and,  in  the  adult, 
presents  round  superficial  depressions  made  by  the  convolutions  of  the 
brain.  These  depressions  are  seldom  deep  enough  to  prevent  the 
internal  periphery  of  the  vault  and  sides  of  the  cranium  from  being 
nearly  parallel  with  their  external  surface. 

On  the  Vault,  or  arch,  are  to  be  seen,  on  the  middle  line,  the  internal 
frontal  spine  (crista  frontalis],  extending  from  the  ethmoid  bone  half 
way  or  more  up  the  os  frontis :  also,  the  gutter  for  the  longitudinal 
sinus,  leading  from  this  spine  along  the  sagittal  suture,  and  terminating 
at  the  internal  occipital  protuberance.  On  either  side  of  this  gutter 
are  the  arborescent  channels,  made  by  the  great  middle  artery  of  the 
dura  mater.  In  this  section,  we  also  see  the  internal  face  of  the  os 
frontis,  excepting  its  orbitar  processes,  the  parietal  bones ;  and  the 
superior  fossae  in  the  occipital  bone,  for  the  posterior  lobes  of  the 
cerebrum. 

The  base  of  the  cranium  internally  presents  a  very  unequal  surface, 

Fig.  50. 


A  view  of  the  internal  surface  of  the  base  of  the  Cranium,  after  the  vault  has  been  removed. 
1, 1.  Anterior  fossa  for  the  anterior  lobe  of  the  cerebrum.  2.  Lesser  wing  of  the  sphenoid  bone.  3.  Crista 
galli.  4.  Foramen  cce cum.  5.  Cribriform  plate.  6.  Processus  olivaris.  7.  Foramen  opticum.  8.  An- 
terior clinoid  process.  9.  Groove  for  the  carotid  artery.  10.  Greater  wing  of  the  sphenoid  bone. 
11.  Middle  fossa  for  the  middle  lobe  of  the  cerebrum.  12.  Petrous  portion  of  the  .temporal  bone. 
13.  Sella  turcica.  14.  Basilar  gutter  for  the  medulla  oblongata.  15.  Foramen  rotundum.  16.  Foramen 
ovale.  17.  Foramen  spinale.  18.  Posterior  fossa  for  the  cerebellum.  19.  Groove  for  the  lateral  sinus. 
20.  Ridge  for  the  falx  cerebelli.  21.  Foramen  nrignum.  22.  Meatus  auditorius  internus.  23.  Poste- 
rior foramen  lacerum  for  the  jugular  vein. 


SURFACE  OF  THE  CRANIUM.  179 

abounding  in  deep  depressions,  processes,  and  foramina.  On  its  middle 
line,  extending  from  before  backwards,  the  following  objects  should 
be  remarked :  The  foramen  coecum  at  the  front  of  the  crista  galli, 
and,  at  either  side  of  the  latter,  the  ethmoidal  gutter,  perforated  with 
holes.  These  gutters  are  bounded,  laterally,  by  the  internal  margin 
of  the  orbitar  processes  of  the  os  frontis,  and  behind  by  the  sphenoid 
bone.  At  the  fore  exterior  part  of  the  gutter  is  the  oblong  foramen, 
for  transmitting  to  the  nose  the  internal  nasal  nerve,  and  about  half  an 
inch  behind  this  foramen,  in  the  suture,  with  the  os  frontis,  is  the  inner 
orifice  of  the  foramen,  called  the  anterior  internal  orbitar,  which  leads 
the  same  nerve  from  the  orbit.  Immediately  behind  the  ethmoidal 
fossse  the  sphenoid  bone  presents  a  plain  surface,  upon  which  are  placed 
the  olfactory  nerves  and  the  contiguous  part  of  the  brain.  Behind 
this  plane,  is  the  fossa,  running  from  one  optic  foramen  to  the  other, 
for  lodging  the  optic  nerves.  Behind  this,  again,  is  the  sella  turcica, 
or  pituitary  fossa,  bounded  at  its  two  anterior  angles  by  the  anterior 
clinoid  processes,  and  behind  by  the  posterior  clinoid  process.  Posterior 
to  the  latter  is  a  plain  square  surface  (the  clivus  or  declivity)  of  the 
sphenoid  bone,  continuous  with  the  internal  surface  of  the  cuneiform 
process  of  the  os  occipitis.  On  the  latter  is  the  depression  called 
basilar  gutter,  for  receiving  the  pons  Varolii,  also  the  medulla  oblongata, 
and  which  is  bounded  below  by  the  great  occipital  foramen.  From  this 
foramen  to  the  internal  occipital  protuberance,  proceeds  the  inferior 
limb  of  the  occipital  cross. 

On  both  sides  of  the  ethmoidal  bone  is  a  convex  surface,  called, 
however,  the  anterior  fossae  of  the  base  of  the  cranium,  and  formed  by 
the  orbitar  processes  of  the  os  frontis  and  the  little  wings  of  the  sphe- 
noid bone,  for  lodging  the  anterior  lobes  of  the  cerebrum.  This  surface 
is  terminated  behind  by  the  rounded  edge  of  the  little  wing,  which  is 
received  into  the  fissure  between  the  anterior  and  middle  lobes  of  the 
brain.  Just  anterior  to  this  edge  is  the  fronto-sphenoidal  suture. 

On  the  sides  of  the  sella  turcica  are  the  middle  fossae  of  the  base  of 
the  cranium  for  lodging  the  middle  lobes  of  the  cerebrum.  They  are 
very  wide  externally,  where  they  are  bounded  by  the  squamous  portion 
of  the  temporal  bones,  but  narrow  internally,  where  they  are  bounded 
by  the  Sella  Turcica.  The  little  wings  of  the  sphenoidal  bone  termi- 
nate them  in  front,  and  form  there  a  crescentic  edge  hanging  over  their 
cavity.  Their  posterior  margin  is  the  superior  ridge  of  the  petrous 
bone.  This  bone  is  placed  very  obliquely,  inwards  and  forwards,  and 
at  its  point,  almost  reaches  the  posterior  clinoid  process.  At  the  ante- 
rior part  of  the  fossa,  is  the  sphenoidal  fissure  or  foramen  of  the  sphe- 
noidal bone.  Just  above  the  base  of  this  fissure  is  the  foramen  optieuin, 
partially  concealed  by  the  anterior  clinoid  process.  Just  below  the  bas 
of  the  fissure  is  the  foramen  rotunduin.  At  the  point  of  the  petrous 
bone,  by  the  side  of  the  posterior  clinoid  process,  is  the  anterior  orifice 
of  the  carotid  canal.  On  a  line  with  the  latter,  exteriorly,  is  the  fora- 
men ovale.  Two  lines  behind  the  latter  is  the  foramen  spinale.  The 
groove  formed  by  the  middle  artery  of  the  dura  mater  may  be  traced 
from  the  foramen  spinale  along  the  anterior  margin  of  the  squamous 
bone.  Near  the  upper  part  of  this  bone  the  groove  bifurcates ;  the 


180  SKELETON. 

larger  channel  runs  upwards  into  a  groove  on  the  tip  of  the  great  sphe- 
noidal  wing  into  the  principal  groove  of  the  parietal  bone,  which  com- 
mences at  the  temporal  angle  of  the  latter.  The  smaller  groove  runs 
horizontally  backwards,  and  just  above  the  base  of  the  petrous  bone  is 
continued  also  in  the  parietal  bone.  On  the  front  of  the  petrous  por- 
tion may  be  seen  the  hiatus  Fallopii.  The  sphenoidal  suture  runs 
through  these  fossse,  in  the  examination  of  which,  the  reception  of  the 
spinous  process  of  the  sphenoid  bone,  between  the  squamous  and  petrous 
portions  of  the  temporal,  will  be  readily  understood. 

On  each  side  of  the  foramen  magnum  occipitis  are  the  two  posterior 
fossae  of  the  base  of  the  cranium,  formed  by  the  posterior  faces  of  the 
petrous  bones,  the  angles  of  the  mastoid  portions  of  the  temporal  bones, 
and  by  that  surface  of  the  occipital  bone  below  its  horizontal  ridges. 
These  two  fossse  are  very  partially  separated  by  the  inferior  ridge  of 
the  occipital  cross  and  receive  the  hemispheres  of  the  cerebellum.  The 
additament  of  the  lambdoidal  suture  traverses  these  fossse.  At  the 
junction  between  the  petrous  bone  and  the  basilar  process  of  the  occi- 
pital, in  the  course  of  the  suture,  is  a  groove  for  the  inferior  petrous 
sinus.  The  groove  conducts  to  the  posterior  foramen  lacerum,  which 
has  a  small  part  separated  from  it  by  the  little  spine  of  the  petrous 
bone,  which,  with  the  assistance  of  the  dura  mater,  forms  a  distinct 
foramen  for  the  eighth  pair  of  nerves.  The  posterior  foramen  lacerum- 
being  common  to  the  temporal  and  occipital  bones,  is  occasionally  much 
larger  on  the  right  than  on  the  left  side ;  in  which  case,  the  groove  that* 
leads  from  it  along  the  angle  of  the  temporal  bone,  the  inferior  corner 
of  the  parietal,  and  the  horizontal  limb  of  the  occipital  cross,  is  also 
larger.  Above  the  foramen  lacerum  are  the  meatus  auditorius  internus, 
and  the  internal  orifice  of  the  aqueduct  of  the  vestibule.  Between  the 
foramen  lacerum  and  foramen  magnum  occipitis,  is  the  anterior  condy- 
loid  foramen.  The  two  posterior  fossae  of  the  base  of  the  cranium 
contain  the  cerebellum. 


SECT.  IV. — OF  THE  EXTERNAL  SURFACE  OF  THE  HEAD. 

Anatomists  consider  the  external  surface  of  the  head,  or  its  peri- 
phery, as  forming  or  representing  three  ovals  and  two  triangles,  each 
of  which  constitutes  a  region.  The  first  oval  is  the  whole  superior  con- 
vex part  of  the  cranium ;  or,  in  other  words,  the  external  surface  of  its 
vault.  The  second  oval  is  formed  by  the  inferior  surface  of  the  cranium, 
and  of  the  face.  The  third  oval  is  formed  by  the  lower  front  part  of 

he  os  frontis,  and  by  the  face.     Each  side  of  the  head  forms  one  of 

he  triangular  regions. 

The  superior  region  is  so  simple,  and  its  parts  have  been  so  closely 
sketched,  that  it  is  unnecessary  to  repeat  the  description. 

The  inferior  region,  or  oval,  extends  from  the  chin  to  the  occipital 
protuberance,  and  is  bounded  in  its  transverse  diameter  by  the  superior 
semicircular  ridges  of  the  os  occipitis,  by  the  mastoid  processes,  and 
by  the  rami  and  base  of  the  lower  jaw.  This  surface  is  subdivided  into 
Palatine,  Guttural,  and  Occipital  sections  or  regions. 


SURFACE  OF  THE  HEAD.  181 

The  Palatine  region  or  section,  is  formed  by  the  superior  maxillary 
and  palate  bones  above,  and  by  the  inferior  maxillary  bone  laterally 
and  below.  It  is  a  deep  fossa,  the  circumference  of  which  is  repre- 
sented by  the  letter  U,  the  open  part  being  behind.  The  whole  upper 
surface  of  the  palatine  region  presents  a  number  of  small  rough  eleva- 
tions and  fossse,  for  the  attachment  of  the  lining  membrane  of  the 
mouth.  The  surface  is  divided  into  two  equal  parts  by  the  long  or 
middle  palate  suture,  which  is  crossed  at  its  posterior  part  by  the  trans- 
verse palate  suture.  The  posterior  margin  of  the  hard  palate  is 
concave  on  each  side  of  the  mouth,  and  from  it  is  suspended  the  soft 
palate.  The  point  in  the  centre  of  this  margin  (spina  nasalis  posterior) 
gives  origin  to  the  azygos  uvulae  muscle. 

Fig.  51. 


An  external  view  of  the  base  of  the  Cranium.  1.  The  hard  palate.  2.  Foramen  incisivum.  3. 
Palate  plate  of  the  palate  bone.  4.  Cresceutic  edge  for  the  soft  palate.  5.  The  vomer.  sepa- 
rating the  posterior  nares.  6.  Internal  pterygoid  process  of  the  sphenoid  bone.  7.  Pterygoid 
fossa.  8.  External  pterygoid  process.  9.  Temporal  fossa  below  the  zygomatic  arch.  10.  Basilar 
process.  11.  Foramen  magnum.  12.  Foramen  ovale.  13.  Foramen  spinale.  14.  Glenoid  fossa.  15. 
Meatus  auditorius  externus.  16.  Foramen  lacerum  anterius.  17.  Carotid  foramen.  18.  Foramen 
lacerumposterius.  19.  Styloid  process.  20.  Stylo-mastoid  foramen.  21.  Mastoid  process.  22.  The 
condyles  of  the  occipital  bone.  23.  Posterior  condyloid  foramen. 

The  foramina  on  this  surface  are  the  anterior  palatine  or  foramen 
incisivutn,  in  the  long  palate  suture  just  behind  the  incisor  teeth  ;  and 
on  either  side,  behind,  between  the  palatine  and  pterygoid  process  of 
the  palate  bone,  bounded  exteriorly  by  the  upper  maxillary,  is  the  pos- 
terior palatine  foramen.  About  one  or  two  lines  behind  this  is  another 
foramen,  in  the  base  of  the  pterygoid  process  of  the  palate  bone, 
through  which  pass  fibrillse,  of  the  same  nerve  that  occupies  the  pos- 
terior palatine  foramen.  The  posterior  palatine  foramen  also  transmits 
an  artery  to  the  soft  palate,  the  mark  of  whose  course  may  be  seen  at 
the  base  of  the  alveolar  processes  for  the  molar  teeth. 

The  internal  surface  of  the  lower  jaw  has  been  sufficiently  described 
in  the  account  of  that  bone. 

The  depth  of  the  palatine  fossa  depends  on  the  state  of  the  teeth. 


4 


JLU«     I 


| 


182  SKELETON. 

When  they  are  removed  by  old  age,  and  the  alveolar  processes  also, 
what  was  palatine  fossa  of  the  upper  maxilla  is  almost  a  plain  surface  ; 
and  in  many  instances  of  extreme  old  age  the  palatine  fossa  is  wholly 
obliterated,  excepting  the  part  formed  by  the  remains  of  the  lower  jaw. 
The  separation  from  the  nose  is  also  extremely  thin,  and  not  unfre- 
quently  imperfect.  The  transverse  diameter  of  the  mouth  is  much 
decreased  in  consequence  of  the  absorption  of  the  alveolar  processes 
taking  place,  from  their  outside  towards  the  inside. 

The  guttural  region  of  the  base  of  the  head  is  formed  by  the  cunei- 
form process  of  the  os  occipitis,  in  the  centre ;  by  the  inferior  face  of 
the  petrous  bones,  laterally  and  behind ;  by  the  body  and  spinous  pro- 
cess of  the  sphenoid  bone,  in  front  and  laterally  ; '  and  by  the  several 
bones  contributing  to  the  orifice  of  the  posterior  nares. 

It  is  bounded  anteriorly  by  the  pterygoid  fossae  and  the  openings  of 
the  nose,  and  behind  by  the  mastoid  processes  and  by  the  condyles  of 
the  os  occipitis.  It  consists,  consequently,  in  one  part,  which  is  hori- 
zontal, and  in  another  which  is  vertical.  In  regard  to  the  horizontal 
portion,  its  inequalities,  processes,  and  fossae  have  been  already  stated. 
The  relative  position  of  its  foramina  cannot,  however,  be  studied  except 
in  the  united  bone.  The  following  rules  will  afford  some  assistance  in 
determining  their  position  even  on  the  living  body. 

A  line  passing  from  the  anterior  margin  near  the  base  of  one  mas- 
toid process  to  the  corresponding  part  of  the  other,  will  subtend  the 
stylo-mastoid  foramina  and  the  posterior  margin  of  the  foramina  lacera; 
it  will  also  touch  the  base  of  the  styloid  processes  and  the  condyles 
of  the  occiput.  A  line,  three-eighths  of  an  inch  in  advance  of  this,  run 
through  the  middle  of  the  meatus  auditorius  externus,  will  indicate  the 
posterior  margins  of  the  glenoid  cavities,1  intersect  the  inferior  end  of 
the  carotid  canals  or  foramina,  and  the  anterior  margins  of  the  anterior 
condyloid  foramina.  Another  line,  one-fourth  of  an  inch  in  advance 
of  the  latter,  will  cut  through  the  centre  of  the  glenoid  cavity,  and 
subtend  the  styloid  process  of  the  sphenoid  bone  and  the  bony  orifice 
of  the  Eustachian  tube  in  the  temporal  bone.  A  line  passing  between 
the  external  ends  of  the  tubercles  of  the  temporal  bones  will  subtend 
the  foramina  ovalia  and  the  foramina  lacera  anteriora.  The  foramen 
spinale  is  about  equi-distant  from  the  last  two  lines. 

The  foramen  lacerum  anterius,  being  at  the  point  of  the  petrous  bone, 
is  occasioned  by  the  latter  not  filling  up  the  space  between  itself  and 
the  sphenoidal  and  the  occipital  bone.  The  deficiency  is  supplied,  in 
the  recent  state,  by  cartilage.  Precisely  opposite  to  the  point  of  the 
petrous  bone  is  the  posterior  orifice  of  the  foramen  pterygoideum,  from 
which  emerges  the  pterygoid  nerve,  and  penetrating  this  cartilage  im- 
mediately divides  into  two  branches ;  that  going  to  the  carotid  canal 
becomes  one  of  the  roots  of  the  sympathetic  nerve,  and  the  other, 
ascending  into  the  cranium,  becomes  the  Vidian  nerve  or  superficial 
petrous. 

The  vertical  portion  of  the  guttural  region  presents  the  posterior 
orifices  of  the  nostrils,  separated  from  each  other  by  the  vomer.  On 


1  By  glenoid  cavity  in  this  paragraph  is  meant  the  whole  of  the  depression  in  the  tem- 
poral bone,  and  not  merely  the  surface  for  the  condyle  of  the  lower  jaw. 


SUKFACE  OF  THE  HEAD.  183 

each  side  are  the  pterygoid  processes  of  the  sphenoid  bone,  and  above, 
is  its  body.  The  pterygoid  fossa,  formed  between  the  external  and  in- 
ternal process,  and  the  long  unciform  termination  of  the  latter  with 
the  broader  and  shorter  termination  of  the  former,  will  also  be  ob- 
served. 

The  Occipital  region  of  the  base  of  the  head,  placed  immediately 
behind  the  other,  may  be  considered  to  include  the  mastoid  processes, 
and  the  foramen  magnum  occipitis,  and  to  be  bounded  behind  by  the 
tuber  of  the  occiput  and  its  superior  transverse" ridges.  Its  marks  have 
been  sufficiently  dwelt  upon,  in  the  description  of  the  os  occipitis. 

The  third  oval  will  be  described  in  detail  in  a  short  time. 

On  the  side  of  the  head,  where  we  consider  the  triangular  region  to 
exist,  the  arch  formed  by  the  malar  bone  and  the  zygomatic  process  of 
the  temporal,  constitutes  a  very  conspicuous  feature.  The  anterior  abut- 
ment of  this  arch  is  formed  by  the  greater  part  of  the  malar  bone,  and 
a  considerable  portion  of  the  malar  process  of  the  superior  maxillary. 
The  posterior  abutment  is  formed  by  the  root  of  the  zygomatic  pro- 
cess of  the  temporal  bone.  Its  superior  margin  is  thin,  for  the  inser- 
tion of  the  temporal  aponeurosis:  the  inferior  margin  is  thick,  and  is 
divided,  by  a  projection  in  its  middle,  into  an  anterior  and  a  posterior 
surface,  marking  the  origins  of  the  two  portions  of  the  masseter  mus- 
cle. There  is  a  very  considerable  vacancy  between  the  zygoma  and 
the  side  of  the  head,  occupied  by  the  coronoid  process  of  the  lower  jaw, 
the  temporal  and  the  external  pterygoid  muscles.  The  coronoid  pro- 
cess is  just  within  the  zygomatic  arch,  and  its  tip  rises  three  or  four 
lines  above  its  inferior  margin. 

The  large  depression  within  the  zygoma  is  the  temporal  fossa.  All 
that  portion  of  the  side  of  the  head,  beneath  the  ridge  called  parietal, 
leading  from  the  external  angular  process  of  the'os  frontis,  and  running 
along  the  surface  of  the  parietal  bone,  is  tributary  to  the  temporal 
fossa.  The  bones,  therefore,  which  contribute  to  form  it,  are  the 
frontal,  the  parietal,  the  temporal,  the  great  wing  and  the  external 
pterygoid  process  of  the  sphenoid  bone,  and  the  posterior  face  of  the 
superior  maxillary  and  malar  bones.  The  arrangement  of  the  squamous 
suture  is  well  seen  in  this  fossa,  also  the  junction  of  the  pterygoid  bone 
with  the  parietal  and  frontal,  by  the  overlapping  of  the  great  wing  of 
the  former.  At  the  inferior  part  of  the  latter,  is  the  pointed  process, 
from  which  one  head  of  the  external  pterygoid  muscle  arises. 

At  the  bottom  of  the  temporal  fossa  there  is  a  narrow  slit  partitioned 
from  the  nose  by  the  nasal  plate  of  the  palate  bone.  This  slit,  from 
its  position  between  the  pterygoid  process  of  the  sphenoid  and  the  ^ 
upper  maxillary,  is  called  the  Pterygo-maxillary  fossa.  It  is  triangular,^ 
the  base  being  upwards  and  the  point  downwards.  .  The  base  reaches 
to  the  bottom  of  the  orbit.  From  the  base  there  leads  into  the  nose  the 
spheno-palatine  foramen  for  transmitting  the  lateral  nasal  nerve  and 
blood-vessels.  Externally  to  this  foramen,  and  somewhat  above  it,  is 
the  foramen  rotundum  for  the  upper  maxillary  nerve.  On  a  level  with 
the  spheno-palatine  foramen,  and  running  horizontally  through  the  base 
of  the  pterygoid  process,  is  the  pterygoid  foramen  for  the  nerve  of  the 


I 


184  SKELETON. 

same  name.  Running  vertically  downwards  from  the  point  of  the 
pterygo-maxillary  fossa,  is  the  posterior  palatine  canal  for  transmitting 
the  nerve  and  artery  of  the  same  name.  The  upper  part  or  base  of 
the  pterygo-maxillary  fossa  is  continuous  with  a  large  fissure  in  the 
bottom  of  the  orbit  called  the  Spheno-maxillary. 


SECT.  V. — OF   THE  NASAL  CAVITIES. 

The  nose  consists  of  two  large  cavities  or  fossae,  in  the  middle  of  the 
bones  of  the  upper  jaw,  and  has  a  very  irregular  surface.  Its  cavities 
are  separated  from  one  another  by  a  vertical  septum,  consisting  of  the 
vomer  and  of  the  nasal  lamella  of  the  ethmoid  bone.  This  septum 
presents  a  surface  which  is  perfectly  plain,  with  the  exception  that  in 
some  subjects  it  is  slightly  convex  on  one  side,  and  concave  on  the 
other.  It  is  deficient  in  front. 

The  upper  part  of  either  nostril  is  formed  by  the  cribriform  plate  of 
the  ethmoid  bone:  in  front  of  this  the  surface  is  very  oblique,  being 
made  by  the  ossa  nasi;  posteriorly  there  is  a  vertical  gutter  on  the 
body  of  the  sphenoid  bone,  in  the  middle  of  which  is  the  orifice  of  the 
sphenoidal  cell.  The  distance  between  the  cellular  part  of  the  ethmoid 
and  the  septum  nasi  is  not  more  than  three  lines.  The  double  row 
of  foramina  in  the  cribriform  plate  is  very  well  seen,  also  the  foramen 
at  its  anterior  part  for  transmitting  the  nasal  branch  of  the  ophthalmic 
nerve ;  the  groove  formed  by  the  latter  on  the  posterior  face  of  the 
ossa  nasi  is  also  very  distinct. 

The  bottom  of  either  nostril,  called  its  floor,  is  formed  by  the  palate 
process  of  the  superior  maxillary  and  palate  bones;  it  is  somewhat 
concave,  and  about  half  an  inch  wide ;  its  width,  however,  is  not  uni- 
form, as  it  is  sometimes  wider  or  narrower  in  front  than  it  is  in  the 
middle.  In  it  is  seen  the  upper  orifice  of  the  foramen  incisivum,  at  the 
anterior  point  of  the  vomer. 

The  external  or  orbitar  surface  of  the  nasal  cavity  is  very  irregular, 
presenting  a  number  of  projections  and  fossae,  over  which  the  Schnei- 
derian  membrane  is  displayed.  It  is  formed  by  the  upper  maxillary, 
the  ethmoid,  the  unguiform,  the  palate,  the  nasal,  the  lower  spongy,  and 
the  sphenoid  bones.  In  the  middle  of  the  posterior  part  of  the  ethmoid 
is  the  upper  meatus  of  the  nose,  a  deep  fossa,  bounded  above  by  the 
cornet  of  Morgagni,  or  the  superior  turbinated  bone,  and  receiving  the 
contents  of  the  posterior  ethmoidal  cells,  by  one  or  more  orifices.  At 
the  posterior  termination  of  this  fossa  is  the  spheno-palatine  foramen. 
The  middle  spongy  bone  forms  the  lower  boundary  of  the  ethmoid; 
between  it  and  the  lower  spongy  or  turbinated  bone,  is  the  middle  meatus 
f  the  nose,  a  fossa  of  considerable  size,  but  of  unequal  surface.  At 
the  fore  part  of  the  middle  meatus  is  a  vertical  projection,  formed  by 
the  ductus  ad  nasum  and  lachrymal  fossa.  Just  behind  this  ridge,  is 
an  interval  between  it  and  the  anterior  part  of  the  ethmoid,  through 
which  the  os  unguis  may  be  seen.  When  the  middle  spongy  bone  is 
broken  off,  immediately  beneath  its  anterior  part,  a  channel  obliquely 
vertical  is  seen  in  the  ethmoid,  which  leads  to  the  frontal  sinus,  through 
the  anterior  ethmoidal  cell.  This  cell,  from  its  peculiar  shape  and  func- 


NASAL  CAVITIES — ORBITS  OF  THE  EYES.  185 

tion,  is  called  infundibulum.  Behind  this  oblique  channel  is  another 
oblique  channel,  parallel,  but  smaller;  in  which  several  orifices  maybe 
found  of  the  anterior  ethmoidal  cells.  The  anterior  channel  has,  in- 
deed, for  the  ethmoidal  cells,  other  orifices  besides  the  infundibulum, 
•which  are  smaller,  and  below  the  latter.  It  is  bounded  in  front  by  a 
sharp,  thin  ridge  of  the  ethmoid,  the  lower  extremity  of  which  con- 
tributes to  close  the  large  opening  into  the  sinus  maxillare. 

Commonly,  about  the  middle  of  the  middle  meatus  of  the  nose,  but 
varying  very  much  in  different  subjects,  is  the  orifice  of  the  sinus  max- 
illare, or  antrum  Highmorianum.  Its  precise  situation  and  direction 
are  so  very  uncertain,  that  its  orifice  is  found  with  some  difficulty  in 
the  fresh  state,  in  a  great  number  of  persons.  Not  unfrequently  I  have 
seen  this  orifice  high  up,  under  the  anterior  extremity  of  the  middle 
spongy  bone. 

The  inferior  meatus  of  the  nose  is  bounded  above  by  the  lower 
spongy  bone,  and  below  by  the  palate  processes.  It  extends  the  whole 
length  of  the  nostril.  At  the  anterior  part  of  this  meatus  above,  is 
the  orifice  of  the  ductus  ad  nasum,  which  communicates  with  the  orbit 
of  the  eye. 

The  nostril  presents  an  increased  width,  anterior  to  the  points, 
where  the  spongy  bones  cease:  this  space  is  bounded  on  the  orbitar 
side  by  the  nasal  bone,  and  the  nasal  process  of  the  upper  maxillare. 
There  is  an  increase  of  transverse  diameter  also  at  the  posterior  part 
of  the  nostril,  behind  the  points  where  the  spongy  or  turbinated  bones 
cease.  This  space  is  bounded  externally  by  the  nasal  plate  of  the  palate 
bone,  and  by  the  internal  pterygoid  process. 

The  posterior  nares,  or  orifices  of  the  nostrils,  are  oval,  and  are  com- 
pletely separated  by  the  posterior  margin  of  the  vomer.  In  the  dried 
skeleton,  on  the  contrary,  the  anterior  nares  have  a  common  orifice, 
from  the  deficiency  of  the  bony  septum  between  them. 


SECT.  VI. — ORBITS  OF  THE  EYES. 

The  orbits  of  the  eyes  are  the  conoidal  cavities  in  the  face,  present- 
ing their  bases  outwards  and  forwards,  and  their  apices  backwards;  so 
that  the  diameter  of  either  orbit,  if  continued,  would  decussate  that 
of  its  fellow  in  the  pituitary  fossa  or  sella  turcica.  Seven  bones  con- 
cur in  forming  the  orbit,  to  wit,  the  os  frontis,  the  os  malge,  the  os 
maxillare  superius,  the  os  planum,  the  os  unguis,  the  os  sphenoides,  and 
the  os  palati.  Its  cavity  is  somewhat  quadrangular,  besides  being  co- 
noidal. The  angles  are  particularly  well  marked,  in  most  subjects,  at 
its  base  or  orifice,  which  resembles  an  oblong,  having  its  long  diameter 
in  some  persons  placed  almost  horizontally,  and  in  others  obliquely* 
downwards  and  outwards.  Immediately  within  the  orifice  the  cavity  is 
enlarged,  behind  the  projection  of  the  oi'bitary  ridge  of  the  os  frontis, 
and  the  elevation  of  the  anterior  inferior  margin  of  the  orbit,  so  that 
the  greatest  diameter  is  there  rather  vertical  than  horizontal.  From 
this  point  the  orbit  decreases  gradually  in  size  to  the  sphenoidal  fissure, 
or  the  superior  foramen  lacerum  of  the  orbit  which  forms  its  apex. 
The  internal  walls  of  the  two  orbits  are  nearly  parallel,  in  consequence 


186  SKELETON. 

of  the  cuboidal  figure  of  the  os  ethmoides,  which  is  placed  between 
them. 

The  superior  face  or  roof  of  the  orbit  is  triangular  and  concave:  it 
is  very  thin,  and  presents  but  a  slight  septum  between  the  eye  and  the 
brain.  Almost  the  whole  of  it  is  formed  by  the  orbitar  process  of  the 
os  frontis,  its  point  only  being  made  by  the  little  sphenoidal  wing. 
The  depression  for  the  lachrymal  gland,  at  its  external  anterior  part,  is 
very  perceptible.  The  trochlea,  for  the  superior  oblique  muscle  of  the 
eye,  is  also  well  seen  about  six  or  eight  lines  above  the  point  of  the 
internal  angular  process  of  the  os  frontis.  Just  at  the  outer  side  of 
this  depression  is  the  foramen  or  notch  for  the  supra-orbitar  artery  and 
nerve.  The  optic  foramen  may  be  seen,  very  readily,  passing  through 
the  little  wing  of  the  sphenoid  bone. 

The  inferior  face,  or  the  floor  of  the  orbit,  is  also  triangular  and 
concave,  and  is  formed  principally  by  the  orbitar  process  of  the  upper 
maxillary  bone ;  being  assisted,  however,  at  its  anterior  external 
margin,  by  a  portion  of  the  malar  bone,  and,  at  its  point  behind,  by 
the  orbitar  process  of  the  palate  bone.  The  latter  cannot  be  seen  very 
distinctly  in  the  articulated  bones,  owing  to  its  great  depth  in  the 
orbit;  but,  when  the  external  side  of  the  orbit  is  removed  with  a  saw, 
its  position  is  placed  in  an  interesting  light.  The  floor  of  the  orbit  is 
thinner  than  its  roof,  and  forms  a  very  slight  separation  from  the  max- 
illary sinus.  It  is  terminated  behind  by  the  spheno-maxillary  fissure, 
or  inferior  foramen  lacerum  of  the  orbit;  a  large  slit,  which,  commenc- 
ing at  the  base  of  the  sphenoidal  fissure,  separates  the  great  wing  of 
the  sphenoidal  bone  from  the  ethmoidal,  the  palate,  and  the  upper 
maxillary  bones.  This  fissure  runs  obliquely  outwards,  so  as  to  have 
its  external  extremity  terminated  by  the  malar  bone.  Near  the  ex- 
ternal extremity  is  seen  the  commencement  of  the  infra-orbitar  canal, 
for  transmitting  the  infra-orbitar  nerve  and  artery. 

The  external  face  of  the  orbit  is  also  triangular,  and  very  oblique. 
It  is  formed  by  the  malar  bone,  and  by  the  orbitar  face  of  the  great 
sphenoidal  wing.  It  is  defined  below  by  the  spheno-maxillary  fissure, 
and  above  by  the  suture  which  unites  the  frontal  to  the  malar,  and  to 
the  great  wing  of  the  sphenoidal  bone.  It  is  terminated,  at  the  apex 
of  the  orbit,  by  the  sphenoidal  fissure. 

The  internal  face  of  the  orbit  is  an  oblong  square,  nearly  parallel,  as 
mentioned,  with  the  corresponding  face  of  the  other  orbit.  It  is  formed 
principally  by  the  orbitar  face  of  the  ethmoid,  called  the  os  planum; 
but  at  the  apex  of  the  orbit  a  small  portion  of  the  body  of  the  sphenoid 
bone  contributes  to  it,  and  anteriorly  is  the  os  unguis.  It  is  bounded 
behind  by  the  sphenoidal  fissure,  in  front  by  the  lachrymal  ridge  (crista 
lachrymalis)  on  the  nasal  process  of  the  os  maxillare  superius,  and 
above  and  below  by  the  upper  and  lower  ethmoidal  sutures.  In  the 
upper  of  these  sutures  there  are  generally  two,  but  sometimes  three 
orbital,  or  ethmoidal  foramina;  the  anterior  of  which  transmits  the 
anterior  ethmoidal  artery  and  vein,  and  the  internal  nasal  nerve,  to 
the  nose ;  the  posterior  transmits  the  posterior  ethmoidal  artery  and 
vein  to  the  same. 


THE  FACE.  187 

The  lachrymal  fossa  is  well  worthy  of  attention :  it  is  seen  to  com- 
mence small  at  the  upper  part  of  the  os  unguis,  and  to  increase  in  size 
till  it  is  formed  by  the  upper  maxillary  and  the  inferior  spongy  bones 
into  a  complete  canal,  the  ductus  ad  nasum,  leading  to  the  nose.  The 
direction  of  the  canal  is  almost  vertically  downwards,  inclining  very 
slightly  backwards.  It  was  stated,  that  the  fossa  in  the  fore  part  of 
the  os  unguis  is  sometimes  supplanted  by  the  increased  breadth  of  the 
nasal  process,  a  fact  of  some  importance  to  an  operator  for  fistula 
lachrymalis. 


SECT.    VII. — OF   THE    FACE,    TOGETHER   WITH    SOME    REMARKS    ON    THE 
FACIAL  ANGLE,  AND  ON  NATIONAL  PECULIARITIES. 

The  anterior  oval  of  the  head  extends  from  the  frontal  protube- 
rances to  the  base  of  the  lower  jaw,  and  from  the  malar  bone  of  one 
side  to  the  malar  of  the  other  inclusively.  This  oval  is  divided  into 
two  symmetrical  or  equal  halves,  by  the  vertical  suture,  which  unites 
the  bones  of  the  opposite  sides  of  the  face. 

In  the  infant,  the  frontal  protuberances  are  always  well  marked, 
from  their  being  the  centres  of  ossification  for  the  two  halves  of  the 
os  frontis ;  in  the  adult,  they  are  frequently  not  raised  above  the  com- 
mon level  of  the  bone.  The  superciliary  protuberances  just  above  the 
internal  half  of  the  orbitary  or  superciliary  ridges  are  generally  some- 
what prominent,  but  they  vary  very  much  in  this  respect  in  different 
individuals.  Between  these  ridges  the  frontal  bone  is  sometimes  raised 
into  a  vertical  elevation  (crista  frontalis  externd),  continuous  with 
the  dorsum  of  the  nose,  as  is  more  frequently  seen  in  young  persons. 

The  nose,  or  pyramidal  convexity,  formed  by  the  nasal  processes, 
of  the  superior  maxillary,  and  by  the  nasal  bones,  is  concave  above, 
and  extremely  prominent  below.  The  prominence  of  it  depends  upon 
the  development  of  the  ossa  nasi.  I  have  frequently  seen  the  latter 
curtailed  to  about  one-half,  and  even  one-third  of  their  usual  breadth, 
and  also  diminished  in  length,  which  is  followed  by  an  unusual  flatness 
of  the  nose  :  the  peculiarity  had  been  presented  to  me  for  a  considerable 
time  only  in  negroes,  but,  since  then,  I  have  also  met  with  it  in  the 
skulls  of  white  subjects :  it  is,  however,  much  more  uncommon  in  the 
latter.  The  anterior  orifice  of  the  nose  is  cordiform,  the  base  being 
below :  the  centre  of  the  base  is  marked  by  a  rough  point,  called  the 
anterior  nasal  spine. 

In  skulls  generally  the  inferior  margin  of  the  anterior  bony  naris  is 
in  the  condition  of  a  sharp  semicircular  edge,  but  it  has  been  remarked 
lately1  that  in  the  head  of  the  African,  this  edge  is  generally  fluted,  the 
fluting  beginning  narrow  externally  and  augmenting  in  breadth  as  it 
advances  to  the  anterior  nasal  spine.  The  author  of  this  observation 
considers  this  fluted  edge  as  the  invariable  and  exclusive  characteristic 
of  the  African  head;  a  comparison,  however,  will  show  that  it  oceasion- 

1  By  Mr.  Robert  Frame,  of  New  York,  a  preparer  of  Anatomical  Pieces. 


188  SKELETON. 

ally  exists  also  in  the  Caucasian  head,  but  it  is  by  no  means  compara- 
ble in  frequency  of  occurrence. 

The  cheek  bones  form  on  either  side  of  the  face  a  considerable 
prominence,  depending  much  upon  the  length  of  the  malar  process  of 
the  upper  maxillary  bones.  In  savage  tribes,  this  prominence  is  fre- 
quently a  characteristic  trait,  and  may  depend  upon  the  greater  develop- 
ment-of  the  upper  maxillary  sinuses.  The  elevation  of  the  cheek  bone 
is  always  conspicuous  in  emaciated  subjects,  from  the  fat  around  its 
base  being  absorbed. 

The  alveolar  processes  with  the  teeth  produce,  in  certain  subjects,  a 
very  prominent  projection  in  the  face,  varying,  however,  considerably 
in  different  individuals,  and  in  different  tribes  of  human  beings.  There 
is  but  little  doubt  of  the  organization  of  some  men  being  more  coarse 
and  animal  than  that  of  others,  even  in  members  of  the  same  family.  The 
circumstance  occasionally  manifests  itself  by  unusually  large  and  long 
teeth,  and  by  alveolar  processes  of  corresponding  dimensions.  Savage 
nations  have  almost  invariably  this  peculiarity,  which  is  kept  up  among 
them,  not  only  by  hereditary  influence  from  father  to  son,  but  also  by 
the  actual  habits  of  the  individual  being  productive  of,  and  favorable  to 
this  arrangement.  It  would  be  interesting  to  know  how  far  articles  of 
food  hard  to  masticate  contribute  to,  or  even  produce,  a  greater  develop- 
ment in  the  organs  of  mastication.  Analogy  is  in  favor  of  the  opinion, 
because  the  arms  or  the  legs  are  always  developed  in  proportion  to  the 
vigor  and  frequency  of  the  exercise  to  which  they  are  put.  Plough- 
men have  la^rge  legs.  Blacksmiths  have  large  arms.  Persons  whose 
habits  of  exercise  do  not  call  into  action  any  part  of  the  body,  to  the 
exclusion  of  other  parts,  have  finer  and  more  graceful  forms  than  labor- 
ers. It  is,  therefore,  probable  that  the  ease  and  gracefulness  of  move- 
ment, said  to  mark  the  polished  and  accomplished  man  of  fashion, 
depend  upon  the  harmonious  action  of  his  whole  frame,  derived  from 
this  proportionate  development  of  all  its  parts.  Besides  the  influence 
of  exercise  upon  the  organs  of  mastication,  the  passions  or  faculties  of 
the  mind  not  unfrequently  manifest  themselves  there.  Individuals  of 
unusual  ferocity  and  savageness  have  frequently  large  teeth  and  alve- 
olar processes.  The  gnashing  of  the  teeth  has,  in  all  ages,  been  con- 
sidered one  of  the  most  striking  signs  of  anger. 

While  speaking  of  these  indications  of  man  in  a  savage  and  unculti- 
vated state,  it  will  be  understood  that  I  allude  to  such  tribes  as  are 
engaged  in  the  chase,  and  in  other  active  modes  of  subsistence,  and 
•whose  habits  are  not  settled  down  into  the  agricultural  or  pastoral 
condition.  It  is  quite  possible  for  one  in  the  latter  situation  to  be 
equally  uninstructed,  on  every  point  of  mental  improvement,  and  to  be 
much  inferior  in  capacity  to  one  of  the  former  ;  yet  his  articles  of  food, 
and  the  sensations  and  passions  in  which  he  indulges,  will  give  no  very 
prominent  outline  to  his  face,  but  only  stamp  it  with  the  general 
expression  of  dullness  and  ignorance. 

The  outline  of  the  face  is  marked  also  by  depressions  or  fossae.  Those 
for  the  eyes  and  for  the  nose  have  been  studied,  and  arrest  at  once  the 
attention  of  the  most  superficial  inquirer.  Immediately  below  the  orbit 


FACIAL  ANGLE.  189 

is  the  canine  fossa  formed  in  the  centre  of  the  front  of  the  upper  max- 
illary bone.  Just  above  the  incisor  teeth  of  this  bone  is  the  superior 
incisive  fossa.  Below  the  inferior  incisor  teeth,  on  each  side  also,  is 
the  inferior  incisive  fossa. 

In  most  adults  the  face  projects  somewhat  beyond  the  cranium,  but 
there  is  a  considerable  diversity  in  this  respect  between  different  tribes 
of  human  beings.  Camper,1  who  has  paid  much  attention  to  this 
arrangement,  has  designated  it  under  the  term  of  the  facial  angle, 

Fig.  52. 


A  lateral  view  of  the  Skull,  showing  the  lines  and  direction  of  the  facial  angle. 

which  he  marks  off  by  two  straight  lines.  One  is  drawn  from  the  lower 
front  part  of  the  frontal  bone  to  the  point  called  the  anterior  nasal 
spine  at  the  orifice  of  the  nose,  terminating  between  the  ends  of  the  roots 
of  the  incisor  teeth  of  the  upper  jaw ;  the  other,  from  this  latter  point  to 
the  middle  of  the  meatus  auditorius  externus,  or  thereabouts.  The 
facial  angle  is  included  between  these  two  lines.  In  Caucasian,  or 
European  heads,  this  angle  is  about  eighty  degrees;  in  the  negro,  or 
Ethiopian,  it  is  about  seventy  degrees ;  and  in  the  Mongolian  or  copper- 
colored  man,  about  seventy-five  degrees. 

An  invariable  relation  is  established  between  the  degrees  of  the 
facial  angle,  the  capaciousness  of  the  cranium,  and  the  size  of  the 
nasal  and  of  the  palatine  regions.  The  nearer  the  approach  is  to  a 
rectangle,  the  smaller  is  the  cavity  of  the  nose,  and  of  the  mouth,  and 
the  greater  is  that  of  the  cranium,  thereby  declaring  a  more  volumi- 
nous and  intellectual  brain.  On  the  contrary,  the  more  acute  that 
the  facial  angle  is,  the  smaller  is  the  volume  of  brain,  and  the  larger 
are  the  nose  and  mouth.  This  is  so  frequently  the  case,  that  Bichat 
considers  it  almost  a  rule  in  our  organization,  that  the  development  of 
the  organs  of  taste  and  smell  is  in  an  inverse  ratio  to  that  of  the 
brain,  and  consequently  to  the  degree  of  intelligence. 

This,  like  other  general  rules,  is  subject  to  exceptions,  in  consequence 
of  the  facial  angle  varying  in  its  size,  from  causes  which  have  no  con- 
nection with  the  degree  of  development  of  the  brain.  Thus  an  unu- 
sual prominence  and  thickness  in  the  lower  part  of  the  os  frontis,  from 
an  increased  capaciousness  of  the  sinuses,  will  make  the  facial  angle 

1  Dissertation  sur  les  Differences  du  Visage  chez  les  Hommes,  Utrecht,  1791. 


190  SKELETON. 

appear  less  acute.  The  wasting  of  the  alveolar  processes,  after  the 
loss  of  the  teeth,  will  produce  the  same  result  in  our  measurements  of 
the  facial  angle.  The  heads  of  infants,  previously  to  the  appearance 
and  full  growth  of  the  teeth,  have  always  the  facial  angle  less  acute 
than  the  heads  of  adults :  in  some  cases  an  angle  of  ninety  degrees  is 
presented  in  them.  On  the  contrary,  a  growth  of  teeth,  and  consequently 
of  the  alveolar  processes,  disproportionate  to  the  size  of  the  body  of  the 
upper  jaw,  will  cause  the  facial  angle  to  project  very  considerably  even 
in  an  individual  of  the  Caucasian  race.  Objections  may  also  be 
brought  against  the  indications  of  the  inferior  line.  The  fair  state  of 
this  argument  appears  to  be  that  the  doctrine  of  the  facial  angle, 
though  correct  in  a  majority  of  instances,  has  numerous  exceptions 
from  individual  peculiarities,  and  that  there  is  no  race  of  human  beings 
which  does  not  present  the  facial  angle  in  all  its  ranges,  from  seventy 
to  ninety  degrees. 

With  the  view  to  meet  such  objections,  and  establish  a  rule  of  more 
uniformity,  M.  Cuvier  has  proposed  to  ascertain  results  from  a  vertical 
section  in  the  middle  of  the  head,  by  which  it  appears  that  the  Cauca- 
sian cranium  is  four  times  the  area  of  the  face ;  whereas  in  the  negro 
the  face  is  a  fifth  larger  than  the  Caucasian  face  by  the  same  rule  of 
measurement. 

In  regard  to  the  various  configurations  of  the  human  face  and 
stature,  depending  upon  habits  and  circumstances  continued  through  a 
long  succession  of  ages  and  generations,  the  following  views  of  one* 
who  was  pre-eminently  qualified  to  judge,  and  of  the  highest  authority, 
will  not  be  uninstructive. 

"Although  there  appears  to  be  but  one  human  species,  since  all  its 
individuals  can  couple  promiscuously,  so  as  to  produce  a  prolific  off- 
spring, we  yet  remark  in  it  certain  hereditary  conformations,  which 
constitute  what  are  called  races.  Of  these  there  are  three  which  are 
eminently  distinct  in  appearance  :  they  are  the  white  or  Caucasian ; 
yellow  or  Mongolian  ;  the  negro  or  Ethiopian. 

"  The  Caucasian  race,  to  which  we  belong,  is  distinguished  by  the 
beautiful  oval  form  of  the  head  ;  and  it  is  this  which  has  given  birth  to 
the  most  civilized  nations,  and  to  those  which  have  generally  ruled  over 
the  others.  It  has  some  differences  in  the  shade  of  the  complexion, 
and  in  the  color  of  the  hair." 

"  The  Mongolian  is  known  by  its  prominent  cheek  bones,  flat  face, 
narrow  and  oblique  eyes,  straight  and  black  hair,  thin  beard,  and  olive 
complexion.  It  has  formed  vast  empires  in  China  and  Japan,  and  has 
sometimes  extended  its  conquests  on  this  side  of  the  Great  Desert ;  but 
its  civilization  has  always  remained  stationary." 

"  The  Negro  race  is  confined  to  the  south  of  Mount  Atlas  ;  its  com- 
plexion is  black,  its  hair  woolly,  its  skull  compressed,  nose  flattish ;  its 
prominent  mouth  and  thick  lips  make  it  manifestly  approach  the 

*  Regne  Animal,  par  M.  le  Chev.  Cuvier,  torn  i.  p.  94,  Paris,  1817. 


THE  FACE.  191 

monkey  tribe ;  the  people  which  compose  this  race  have  always  re- 
mained in  a  state  of  barbarism. 

"  The  race  from  which  we  are  descended  is  called  Caucasian,  because 
tradition,  and  also  the  lineage  of  nations,  would  appear  to  trace  it  to 
the  group  of  mountains  situated  between  the  Caspian  and  the  Black 
Sea  (on  the  borders  of  Europe),  from  whence  it  has  radiated  in  every 
direction.  The  people  of  Caucasus,  as  also  the  Georgians  and  Cir- 
cassians, are  considered,  even  at  the  present  day,  the  handsomest  in 
the  world.  The  principal  branches  of  this  race  are  distinguishable  by 
the  analogies  of  language.  The  Armenian  or  Syrian  division  directed 
its  course  towards  the  south,  and  has  given  birth  to  the  Assyrians,  the 
Chaldeans,  and  the  untameable  Arabs,  who,  after  Mahomet,  were  very 
near  becoming  masters  of  the  world ;  to  the  Phenicians,  the  Jews,  and 
the  Abyssinians,  which  were  Arabian  colonies;  and  it  is  very  probable 
that  the  Egyptians  also  are  descended  from  the  same  source.  It  is 
from  this  branch  (the  Syrian),  always  inclined  to  mysticism,  that  the 
most  widely-extended  religions  have  sprung.  Science  and  literature 
have  flourished  among  them  occasionally,  but  always  under  fantastic 
forms,  and  with  a  figurative  style. 

"  The  Indian,  German,  and  Pelasgic  branch  is  infinitely  more  ex- 
tended, and  was  divided  at  a  much  earlier  period ;  we,  nevertheless, 
recognize  the  greatest  resemblance  between  its  four  principal  languages; 
which  are,  the  Sanscrit,  at  present  the  sacred  language  of  the  Hindoos, 
and  mother  of  all  the  dialects  of  Hindostan ;  the  ancient  language  of 
the  Pelasgi,  which  is  the  common  mother  of  the  Greek,  the  Latin,  of 
many  tongues  which  are  now  extinct,  and  of  almost  every  language 
spoken  in  the  south  of  Europe ;  the  Gothic  or  Teutonic,  from  which  are 
derived  the  languages  of  the  North  and  North  West,  such  as  the  Ger- 
man, Dutch,  English,  Danish,  Swedish,  and  their  dialects ;  and  lastly, 
the  language  called  Sclavonian,  from  which  come  those  of  the  north- 
east, as  the  Russian,  Polish,  Bohemian,  &c. 

**  It  is  this  great  and  respectable  branch  of  the  Caucasian  race  which 
has  carried  farthest  Philosophy,  the  Arts  and  Sciences,  and  which  has 
been  for  ages  the  depository  of  them. 

"  This  branch  was  preceded  in  Europe  by  the  Celts,  who  came  from 
the  north,  and  were  formerly  very  much  extended,  but  are  now  confined 
to  the  most  western  parts ;  and  by  the  Cantabrians,  who  passed  from 
Africa  into  Spain,  and  are,  at  present,  almost  confounded  with  the 
numerous  nations  whose  posterity  has  been  blended  in  this  peninsula. 

"  The  ancient  Persians  have  the  same  origin  with  the  Indian  branch ; 
and  their  descendants,  even  at  the  present  day,  bear  the  strongest 
marks  of  affinity  to  the  European  nations. 

"  The  Scythian  or  Tartarian  branch,  first  directing  their  course  to 
the  north  and  north-east,  always  led  erratic  lives  in  the  vast  plains  of 
those  countries ;  and  they  have  only  left  them  to  return  and  destroy 
the  more  comfortable  establishments  of  their  brethren.  The  Scythians, 
who,  at  so  remote  a  period  of  antiquity,  made  irruptions  into  Upper 
Asia ;  the  Parthians,  who  destroyed  there  the  power  of  the  Greeks  and 
Romans;  the  Turks,  who  overthrew  there  that  of  the  Arabs,  and  sub- 
jugated in  Europe  the  unhappy  remnant  of  the  Greek  nation,  were 


192  SKELETON. 

swarms  of  this  stock ;  the  Finlanders  and  the  Hungarians  are  colonies 
of  it,  in  some  measure  astray  among  the  Sclavonian  and  Teutonic 
nations.  The  north  and  east  of  the  Caspian  Sea,  their  original  coun- 
try, are  still  inhabited  by  people  of  the  same  origin,  and  speaking 
similar  languages ;  but  they  are  there  intermixed  with  an  infinity  of  other 
petty  nations,  of  different  origins  and  languages.  The  Tartar  nation 
has  always  remained  more  unmixed  in  all  that  tract  of  country,  extend- 
ing from  the  mouth  of  the  Danube  to  beyond  the  Irtjseh,  from  which 
they  so  long  threatened  Russia,  and  where  they  have  at  last  been  sub- 
dued by  her.  The  Mongolians,  however,  in  their  conquests,  have 
blended  their  blood  with  these  people,  and  many  traces  of  this  inter- 
mixture are  discovered,  principally  among  the  Western  Tartars." 

"  The  Mongolian  race  commences  to  the  east  of  this  Tartar  branch 
of  the  Caucasian,  and  prevails  thence  to  the  Eastern  Ocean.  Its 
branches,  the  Calinucks  and  Halkas,  still  nomadic  or  unsettled,  occupy 
the  Great  Desert.  Thence  have  their  ancestors,  under  Attila,  under 
Genghis,  and  under  Tamerlane,  spread  far  and  wide  the  terror  of  their 
name.  The  Chinese  come  from  this  race,  and  are  not  only  the  most 
anciently  civilized  of  it,  but,  indeed,  of  any  nation  yet  known.  A  third 
branch  (the  Montchoux)  has  recently  conquered  China,  and  continues 
to  govern  it.  The  Japanese  and  Coreans,  and  almost  all  the  hordes 
which  extend  to  the  north-east  of  Siberia,  under  the  domination  of 
Russia,  belong  also  to  it  in  a  great  measure.  If  we  except  a  few 
Chinese  literati,  the  whole  Mongolian  race  is  universally  addicted  to 
the  different  sects  of  the  worship  of  Fo. 

"  The  origin  of  this  great  race  appears  to  have  been  in  the  Altay 
Mountains,1  as  ours  was  in  the  Caucasian ;  but  it  is  impossible  to  follow 
so  well  the  clue  of  its  different  branches.  The  history  of  these  wan- 
dering people  is  as  fugitive  as  their  establishments ;  and  the  records  of 
the  Chinese,  from  being  confined  to  their  own  empire,  afford  us  but 
short  and  vague  accounts  of  the  neighboring  nations.  The  affinities 
of  their  languages  are  also  but  too  little  known  to  guide  through  this 
labyrinth. 

"  The  languages  of  the  north  of  the  peninsula  beyond  the  Ganges, 
and  also  that  of  Thibet,  bear  some  affinity  to  the  Chinese,  at  least  in 
their  monosyllabic  nature,  and  the  people  who  speak  them  are  not 
without  traits  of  resemblance  to  the  other  Mongolian  nations ;  but  the 
south  of  this  peninsula  is  inhabited  by  the  Malays,  a  much  handsomer 
people,  whose  race  and  language  are  spread  over  the  coasts  of  all  the 
islands  of  the  Indian  Archipelago,  and  have  occupied  almost  all  those 
of  the  Southern  Ocean.  On  the  largest  of  the  former,  especially  in  the 
uncultivated  and  savage  parts,  we  find  other  men,  who  have  woolly  hair, 
black  complexion,  and  negro  visage,  and  who  are  all  extremely  bar- 
barous. The  most  known  are  the  Papuas,  a  name  by  which  they  may 
be  generally  denominated. 

"•  It  is  not  easy  to  refer  either  the  Malays  or  Papuas  to  any  one  of  the 
three  great  races ;  but  can  the  former  be  plainly  distinguished  from 
their  neighbors,  the  Caucasian  Hindoos  on  one  side,  and  the  Mongolian 

1  A  range  in  the  north  of  Asia,  about  5000  miles  long. 


F(ETAL  HEAD.  193 

Chinese  on  the  other  ?  We  must  confess  that  we  do  not  find  them  to 
possess  sufficient  characteristics  to  enable  us  to  answer  this  question. 
Are  the  Papuas  negroes,  who  formerly  straggled  along  the  Indian 
Ocean  ?  We  have  neither  drawings  nor  descriptions  sufficiently  clear 
to  reply  to  this  question. 

"  The  inhabitants  of  the  north  of  the  two  continents,  the  Samoiedes, 
the  Laplanders,  and  the  Esquimaux,  sprung,  according  to  some  authori- 
ties, from  the  Mongolian  race.  Agreeably  to  others,  they  are  but  a 
degenerate  offspring  of  the  Scythian  and  Tartarian  branches  of  the 
Caucasian  race. 

"It  is  impossible  to  refer,  satisfactorily,  the  Americans  themselves 
to  either  of  our  races  of  the  old  continent ;  and  yet  they  have  not 
characteristics  precise  and  constant  enough  to  constitute  a^distinct  race. 
Their  copper-colored  complexion  is  not  sufficient ;  their  hair,  which  is 
generally  black,  and  their  scanty  beard,  would  lead  us  to  refer  them 
to  the  Mongolians,  did  not  their  well-marked  features,  and  their 
moderately  prominent  noses,  oppose  such  an  arrangement ;  their  lan- 
guages are  as  innumerable  as  their  tribes,  and  we  have  yet  been  unable 
to  discover  either  any  analogies  among  them,  or  with  those  of  the 
ancient  world."1 


SECT.  VIII. — OF  THE  DEVELOPMENT  OF  THE  FCETAL  HEAD. 

t 

The  foetal  head,  in  very  early  stages  of  gestation,  forms  an  oval 
vesicle,  constituting  the  greater  part  of  the  bulk  of  the  embryo,  and  at 
this  period  has  the  face  scarcely  visible.  The  parietes  of  this  vesicle 
are  formed  by  a  thin  membrane,  consisting  of  two  layers,  the  external 
of  which  is  the  pericranium,  and  the  internal  layer  is  the  dura  mater. 
These  layers  adhere  so  closely,  that  they  cannot  be  accurately  separated 
by  the  knife. 

About  the  third  month  of  the  embryo,  or  even  earlier,  ossification 
may  be  seen  at  several  points  of  the  cranium,  but  more  extensively 
about  its  base.  These  points  are  the  centres  of  ossification,  which 
progressively  increase  towards  their  respective  circumferences,  by  the 
deposit  of  new  bony  matter.  Generally  the  base  of  the  cranium 
begins  to  ossify  before  the  vault,  and  is  entirely  ossified  at  birth,  with 
the  exception  of  a  few  parts,  as  the  clinoid  processes  and  the  ethmoid 
bone. 

The  following  nuclei  of  ossification  show  themselves  between  the 
laminae  of  the  foetal  cranium,  from  the  third  to  the  fourth  month. 
One  at  the  anterior  part,  for  the  centre  of  either  side  of  the  os  frontis  ; 
one  for  the  centre  of  each  parietal  bone,  on  the  upper  side  of  the  head; 
one  on  the  side  of  the  head  below,  for  the  squamous  portion  of  the 
temporal  bone ;  and  there  are  several  for  the  occipital  bone.  These 

1  On  this  subject,  see  also  Lectures  on  the  Physiology,  Zoology,  and  Natural  History 
of  Man,  by  W.  Lawrence.  London,  1822. 

Dictionnaire  des  Sciences  Med.  tome  xxi.    Paris,  1817. 
Histoire  Naturelle  cle  L'Homme,  par  Lacapede.   Paris,  1821. 
Blumenbach  de  Variet.  Gen.  Hum.  Nat.  1794— also  Decades,  1790—1814. 
VOL.  I. — 13 


194  SKELETON. 

points  extend  themselves  in  radii ;  and,  as  the  intervals  between  the 
latter  become  wider  by  their  divergence,  new  radii,  as  observed  else- 
where, are  deposited  between  them.  In  some  of  the  bones,  the  radii, 
from  opposite  points,  in  the  progress  of  ossification  before  and  after 
birth,  meet  and  coalesce :  this  occurs  in  the  os  frontis  and  in  the  os 
occipitis. 

At  birth  the  contiguous  margins  of  the  flat  bones  simply  approach 
each  other,  but  have  not  interlocked.  These  bones  consist  then  of 
but  one  table,  the  edges  of  which  are  very  finely  serrated,  and  thereby 
show  the  radii  of  ossification.  The  edges  are  held  together  by  the 
dura  mater,  internally,  and  the  pericranium,  externally,  but  the  fissure 
between  them  is  very  obvious,  and  so  large  that  it  allows  very  readily 
considerable  motion  and  the  mounting  of  one  bone  upon  the  other  by 
slight  pressure.  It  is  always  to  be  observed  that  the  base  of  the 
cranium  is  an  exception  to  the  latter  rule,  both  from  the  breadth  of  its 
articulating  surfaces,  and  from  its  comparatively  advanced  ossification. 
In  parturition,  therefore,  the  vault  of  the  cranium,  by  its  mobility,  is 
adjusted  to  the  contour  of  the  pelvis,  but  the  base  does  not  yield  in 
either  of  its  diameters  to  the  expulsive  powers  of  the  uterus.  The 
latter  provision,  however  inconvenient  in  parturition,  is  of  the  greatest 
consequence  immediately  afterwards ;  for  without  this  immobility  in 
the  base  of  the  cranium,  whenever  the  weight  of  the  head  was  thrown 
upon  it,  the  pressure  of  the  vertebral  column  would  drive  it  upwards, 
to  the  injury  of  the  brain  and  of  the  nerves  proceeding  from  it.  This 
resistance,  it  may  be  added,  is  still  farther  assisted  by  the  arched  figure 
of  the  base  of  the  cranium.  On  this  subject,  it  is  not  a  little  remarka- 
ble, that  even  the  heads  of  the  hydrocephalic  foetuses  have  the  bones 
of  the  base  fully  ossified,  and  in  contact,  so  as  to  support  the  weight  of 
the  head  in  the  vertical  position. 

Fontaneh. — In  consequence  of  the  flat  bones  of  the  cranium  ossifying 
always  towards  the  circumference,  their  angles,  as  observed,  being  the 
longest  radii  from  their  centres,  are  the  last  in  ossifying.  These  angles 

Fig.  53. 


A  view  of  the  Fcetal  Head,  showing  the  Fontanels.— 1.  Posterior  fontanel.  2.  Line  of  separation 
of  the  parietal  bones.  3.  Anterior  fontanel.  4.  Line  of  separation  of  the  os  frontis.  5,  5.  Coronal 
suture. 


FCETAL  HEAD.  195 

are  commonly  incomplete  at  birth,  and  the  membranous  spaces  which 
represent  them  are  the  Fontanels.  Of  these  there  are  six,  two  on  the 
middle  line  of  the  head,  above,  and  two  on  either  side.  The  former 
afford  highly  important  indications  to  the  accoucheur. 

The  anterior  fontanel  is  the  largest  of  all.  It  is  at  the  fore  part  of 
the  sagittal  suture,  and  is  produced  by  a  deficiency  in  the  angles  of  the 
parietal  bones,  and  of  the  contiguous  angles  of  the  os  frontis.  It  is 
quadrangular  or  lozenge-shaped,  and  the  anterior  angle  is  generally 
longer  than  the  others.  This  is  remarkably  the  case,  when  the  sagittal 
suture  is  continued  down  to  the  root  of  the  nose.  The  posterior  fon- 
tanel is  at  the  other  extremity  of  the  sagittal  suture,  and  as  there  are 
only  three  points  of  bone  defective  there,  two  for  the  parietal  bones, 
and  one  for  the  occipital,  this  suture  is  triangular.  In  many  children, 
at  birth,  it  is  so  far  filled  up  as  to  be  scarcely  visible ;  the  three  mem- 
branous sutures,  however,  which  run  into  it,  make  its  position  suffi- 
ciently discernible  by  the  finger. 

Of  the  two  fontanels,  on  either  side,  one  is  placed  at  the  angle  of 
the  temporal  bone,  where  it  runs  up  between  the  occipital  and  the 
parietal.  The  other  is  in  the  temporal  fossa,  under  the  temporal  mus- 
cle, at  the  junction  between  the  parietal  and  the  sphenoidal  bones. 
These  two  fontanels  are  but  little  referred  to  by  the  accoucheur  in 
delivery,  as  they  are  irregular  and  indistinct.  The  pulsations  of  the 
brain  may  be  readily  felt  through  the  fontanels.  They  ossify  rapidly 
after  birth,  and  are  frequently  closed  completely  by  the  end  of  the 
first  year  ;  but  if  there  be  an  accumulation  of  water  in  the  ventricles 
of  the  brain,  they  remain  open  for  an  indefinite  period. 

The  longest  diameter  of  a  child's  head  is  from  the  vertex  or  posterior 
extremity  of  the  sagittal  suture  to  the  chin,  and  measures  five  inches 
and  a  quarter.  From  the  middle  of  the  frontal  bone  to  the  tubercle  of 
the  occipital  is  four  inches ;  from  one  parietal  protuberance  to  the  other, 
is  about  three  inches  and  a-half. 

At  birth  the  os  frontis  consists,  most  commonly,  of  two  pieces,  united 
by  the  sagittal  suture.  The  parietal  bone  is  a  single  piece,  incomplete 
at  its  angles.  The  temporal  bone  consists  of  three  pieces  :  one  is  the 
squamous,  the  other  is  the  petrous,  and  the  third  is  a  small  ring  which 
afterwards  constitutes  the  meatus  externus  ;  it  is  deficient  in  styloid 
and  mastoid  processes.  The  os  occipitis  is  in  four  pieces  :  one  extends 
from  the  angle  of  the  lambdoidal  suture  to  the  upper  edge  of  the  fora- 
men magnum ;  on  either  side  of  the  foramen  magnum  is  another,  with 
the  condyle  growing  on  it,  and  the  cuneiform  process  is  the  fourth. 
The  ethmoid  bone  is  cartilaginous.  The  sphenoidal  bone  is  in  three 
pieces.  The  body  and  little  wings,  being  united,  form  one ;  the  great 
wing  and  the  pterygoid  process,  being  also  united,  form  on  either  side 
of  the  body  another  piece. 

At  birth  there  is  a  great  disproportion  in  size  between  the  cranium 
and  face.  This  disproportion  diminishes  in  the  progress  of  life,  by  the 
development  of  the  sinuses  and  of  the  alveolar  processes  in  the  latter. 
At  birth,  indeed,  there  is  no  cavity  either  in  the  sphenoidal,  the  frontal, 
or  the  upper  maxillary  bones ;  the  orbitar  and  the  palate  plates  are 
very  near  each  other,  and  the  rudiments  of  the  teeth  are  hidden  in  the 
bodies  of  the  upper  and  lowTer  jaw  bone.  The  latter  consists  of  two 
pieces,  united  by  cartilage  at  the  chin,  and  its  angle  is  very  obtuse. 


196  SKELETON. 


CHAPTER    IV. 
THE  HYOID  BONE  (OS  HYOIDES,  HYOIDE). 

THE  Os  Hyoides  is  placed  at  the  root  of  the  tongue,  within  the  circle 
of  the  lower  jaw.  It  is  an  insulated  bone,  having  no  connection  with 
any  other,  except  by  muscles  and  ligaments.  It  is  said,  very  properly, 
to  resemble  the  letter  U,  and  consists  of  a  body  and  of  two  cornua. 

The  body  is  in  the  middle;  it  is  the  largest  part  of  the  bone,  and 
forms  nearly  a  semicircle.  Its  anterior  face  is  convex,  and  its  upper 
part  is  flattened  by  the  insertion  of  the  muscles  from  the  lower  jaw, 
as  the  genio-hyoideus  and  the  genio-hyoglossus.  The  posterior  face  is 
concave,  for  adjusting  it  to  the  superior  margin  of  the  thyroid  cartilage. 

The  cornua,  one  on  either  side,  are  about  an  inch  long,  and  are  placed 
at  the  extremities  of  the  body,  being  united  to  it  by  the  interposition 
of  cartilage  and  ligarnentous  fibres.  They  are  flattened  above  and  be- 
low rather  than  cylindrical,  and  diminish  towards  the  posterior  extremi- 
ties, where  they  terminate  in  a  round  enlargement,  like  a  head. 

Fig.  54. 


An  anterior  view  of  the  Os  Hyoides.— 1.  The  anterior  convex  side  of  the  body.  2.  The  cornu  majus  of 
the  left  side.  3.  The  cornu  minus  of  the  same  side.  The  cornua  majora  were  ossified  to  the  body  of  the 
bone,  in  this  specimen. 

At  the  fibro-cartilaginous  junction  of  the  cornu  and  body,  on  each 
side,  there  is  a  small  cartilaginous  body  three  or  four  lines  long,  fast- 
ened by  ligamentous  fibres.  It  is  frequently  found  ossified.  This  is 
the  appendix  or  lesser  cornu. 

A  round  ligament,  the  stylo-hyoid,  passes  to  it  from  the  inferior  ex- 
tremity of  the  styloid  process  of  the  temporal  bone.  Sometimes  the 
ossification  of  the  appendix  extends  along  the  substance  of  this  liga- 
ment for  half  an  inch  or  an  inch,  but  it  is  generally  flexible  at  the  root, 
and  on  rare  occasions  ossification  of  the  ligament  is  so  extensive,  as 
to  produce  serious  difficulty  in  talking  and  swallowing,  by  its  reaching 
to  the  styloid  process. 

The  texture  of  this  bone  is  cellular,  with  a  thin  compact  lamina 
externally.  M.  Portal  says,  that  he  has  found  it  carious  from  vene- 
real contamination;  in  which  case,  the  patient  had  been  afflicted  with 
violent  sore  throat  and  purulent  expectoration.  Sauvages  and  Valsalva 
have  each  met  with  a  case,  where,  from  luxation  of  the  cornu,  the 
patient  spoke  with  great  difficulty. 


THE  SHOULDERS.  197 


CHAPTER   V. 
OF  THE  UPPER  EXTREMITIES. 

THIS  portion  of  the  skeleton  is  divided  on  either  side  of  the  body, 
into  shoulder,  arm,  forearm,  and  hand.  The  bones  are  the  clavicle, 
scapula,  os  humeri,  ulna,  radius,  those  of  the  carpus,  the  metacarpus, 
and  the  phalanges. 

SECT.  I. — OF  THE  SHOULDER. 

The  shoulder  consists  of  the  two  bones,  the  clavicle  and  the  scapula, 
and  occupies  the  superior,  lateral,  and  posterior  part  of  the  thorax. 
Its  shape  and  position  are  such,  that  it  augments  considerably  the 
transverse  diameter  of  the  upper  part  of  the  trunk,  taken  as  a  whole: 
while  the  thorax  alone,  at  this  place,  is  actually  smaller  than  it  is  be- 
low. The  clavicle  is  longer,  in  proportion,  in  the  female  than  in  the 
male,  which  increases  in  her  the  transverse  extent  of  the  shoulder,  and 
gives  a  greater  space  on  the  front  of  the  thorax  for  the  development 
of  the  mammae.  This  coincidence  between  the  length  of  the  shoulder 
and  the  development  of  the  mamma  has  been  particularly  noticed  by 
Bichat,  who  says  that  it  is  almost  always  well  marked,  that  very  rarely 
a  voluminous  bosom  reposes  on  a  small  pectoral  space,  or  a  small  bosom 
is  found  upon  a  large  pectoral  space.  In  the  male,  on  the  contrary, 
this  diameter  of  the  trunk  is  increased  principally  by  the  breadth  of 
the  scapula,  which,  from  its  position  on  the  thorax,  and  its  great  size, 
gives  the  bulky  appearance  to  this  part.  It  is  evident  that  these  modi- 
fications in  the  framework  of  the  shoulders  are  connected  with  the 
natural  destinations  of  the  two  sexes.  In  woman  the  length  of  the 
clavicle  is  adverse  to  its  strength,  and  it  is  indistinctly  marked  by  mus- 
cular connections;  whereas,  in  man  it  is  short,  strongly  marked,  and 
large.  Anatomists  who  are  fond  of  extending  such  comparisons,  say, 
also,  very  justly,  that  the  pubes,  which  perform  the  same  office  for  the 
lower  extremities  that  the  clavicles  do  for  the  upper,  that  of  keeping 
the  two  apart,  are,  in  the  female,  both  smaller  and  longer  than  in  the 
male;  that  their  shape  is  not  so  favorable  to  strength  or  locomotion, 
and  has  a  special  view  towards  the  lodgment  of  the  genital  organs,  and 
to  the  passage  of  the  child.  In  man  the  increased  size  of  the  whole 
skeleton,  and  the  greater  development  of  the  muscular  system,  indicate 
that  he  was  intended  for  more  laborious  exertion  than  the  female. 

The  thorax  and  the  shoulder  are  connected  by  a  reciprocal  develop- 
ment, both  being,  when  large,  indicative  of  a  robust  and  vigorous  con- 
stitution ;  and  when  small,  of  a  weakly  one.  As  both  of  these  parts 
are  acted  on  by  the  same  muscles,  the  necessity  of  this  coincidence  is 
sufficiently  apparent.  The  height  of  the  shoulder  depends  upon  the 


198  SKELETON. 

scapula  alone ;  its  elevation,  therefore,  is  greater  in  males  and  in  vigo- 
rous persons  generally,  than  in  females  and  in  weakly  individuals.  The 
direction  of  the  shoulder  is  such,  that  the  articular  face  of  the  scapula 
for  the  os  humeri  looks  outwards,  thereby  proving  that  the  quadruped 
position  in  man  is  unnatural;  for  by  this  direction,  the  weight  of  the 
fore  part  of  the  trunk  is  directed  upon  the  back  part  of  the  capsular 
ligament  of  the  joint  instead  of  upon  the  glenoid  cavity,  as  in  quadru- 
peds. This,  and  many  other  circumstances,  prove  that  the  natural  in- 
tention of  the  upper  extremities  in  the  human  subject  is  to  seize  upon 
objects,  and  not  to  maintain  the  horizontal  position. 

Of  the  Shoulder  Blade  (Scapula,  Omoplate}. 

The  Scapula  is  placed  upon  the  posterior  superior  part  of  the  thorax, 
and  extends  from  the  second  to  the  seventh  rib  inclusively ;  its  poste- 
rior edge  is  nearly  parallel  with  the  spinous  processes  of  the  vertebrae, 
and  not  far  from  them. 

Its  general  form  is  triangular.  It  therefore  presents  two  faces,  of 
which  one  is  anterior,  and  the  other  posterior ;  three  edges,  of  which 
one  is  superior,  another  external,  and  the  third  internal  or  posterior  ; 
and  three  angles,  of  which  one  is  superior,  another  inferior,  and  the 
third  exterior  or  anterior. 

The  posterior  face  of  the  scapula  is  called  its  dorsum  ;  is  somewhat 
convex,  when  taken  as  a  whole  ;  and  is  unequally  divided  by  its  spine 
into  two  surfaces  or  cavities,  of  which  the  lower  is  twice  or  three  times 
as  large  as  the  upper.  The  spine  is  a  very  large  process  that  begins  at 

Fig.  55. 


A  posterior  view  of  the  Scapula  of  the  left  side.  1.  Fossa  supra-spinata.  2.  Fossa  infra-spinata. 
3.  Superior  costa.  4.  Coracoid  notch.  5.  Inferior  costa.  6.  Glenoid  cavity  7.  Inferior  angle. 
8.  The  neck  and  point  of  origin  of  the  long  head  of  the  triceps  muscle.  9.  Posterior  margin,  or 
base.  10.  The  spine.  11.  Smooth  facet  for  the  trapezius  muscle.  12.  Acromion  process.  13. 
Nutritious  foramen.  14.  Coracoid  process. 

the  posterior  edge  of  the  bone,  by  a  small  triangular  face ;  rapidly 
increases  in  its  elevation  and  running  obliquely  towards  the  anterior 


THE  SHOULDERS.  199 

angle,  ceases  somewhat  short  of  it ;  it  is  then  elongated  forwards  and 
upwards,  so  as  to  overhang  the  shoulder  joint,  and  to  form  the  acro- 
mion  process.  The  cavity  above  the  spine  is  owing  principally  to  the 
elevation  of  the  latter,  and  is  called  the  fossa  supra-spinata  ;  it  is  occu- 
pied by  the  supra-spinatus  muscle.  The  cavity  below  the  spine  is- the 
fossa  infra-spinata,  and  is  for  the  infra-spinatus  muscle :  it  is  bounded 
below  by  a  rising  of  the  external  margin  of  the  bone.  The  middle  of 
this  fossa  presents  a  swell  or  convexity,  which  is  a  portion  of  the  general 
convexity  presented  by  the  posterior  face  of  the  bone.  On  a  vertical 
measurement  of  the  scapula  from  the  superior  to  the  inferior  angle, 
the  spine  will  be  found  to  traverse  it  nearly  along  the  base  of  its  upper 
fourth. 

The  spine  of  the  scapula  is  always  prominent  in  the  outline  of  the 
shoulder,  and  has  a  well  secured  base  along  the  whole  of  its  attachment 
to  the  bone,  to  where  it  terminates  in  the  acromion  process.  It  leans 
upwards,  and  from  the  increased  breadth  of  its  summit,  is  concave  both 
above  and  below.  The  summit  itself  is  somewhat  rough,  and  has  inserted 
into  its  superior  margin  the  trapezius  muscle,  while  the  inferior  margin 
gives  origin  to  the  deltoid.  The  little  triangular  face  at  the  commence- 
ment of  the  spine  is  made  by  the  tendon  of  the  trapezius  muscle  gliding 
over  it.  The  acromion  process  arises  from  the  spine  by  a  narrow  neck, 
is  triangular,  nearly  horizontal,  and  overhangs  the  glenoid  cavity,  being 
elevated  about  one  inch  above  it.  It  is  slightly  convex  above  and  con- 
cave below ;  the  external  and  the  internal  margins  are  the  longest. 
The  posterior  margin  is  continuous  with  the  inferior  edge  of  the  spine 
of  the  scapula,  and  the  internal  is  on  a  level  with  the  clavicle.  At  the 
anterior  extremity  of  the  internal  margin,  is  a  small,  oval,  articular  face, 
by  which  the  acromion  unites  with  the  clavicle.  The  margins  of  the 
acromion,  with  the  exception  of  the  internal,  are  rough,  and  give  origin 
to  the  deltoid  muscle. 

The  anterior  or  costal  face  of  the  scapula  is  concave,  and  obtains  the 
name  of  the  subscapular  fossa  or  the  venter.  It  is  occupied  by  the 
subscapular  muscle,  the  divisions  of  which,  by  leaving  deep  interstices 
between  them,  produce  corresponding  ridges  upon  the  bone  that  run 
obliquely  upwards  and  outwards.  Along  the  whole  posterior  margin 
of  this  face  of  the  scapula,  is  inserted  the  serratus  major  anticus. 

The  posterior  or  vertebral  margin  of  the  scapula  is  the  longest  of  the 
three,  and  is  called  the  base.  It  is  not  perfectly  straight,  but  some- 
what rounded,  especially  above  the  spinous  process;  and  has  there, 
varied  degrees  of  obliquity  in  different  persons.  This  margin,  below 
the  spine,  receives  the  rhomboideus  major  muscle,  and  above  the  spine, 
the  levator  scapulae;  at  the  part  between  the  other  two,  the  rhom- 
boideus minor  is  inserted. 

The  external  or  axillary  margin  of  the  scapula,  also  called  the  infe- 
rior costa,  is  much  the  thickest  of  the  three.  A  superficial  fossa  placed 
somewhat  posteriorly,  forming  the  inferior  boundary  of  the  fossa  infra- 
spinata,  begins  about  two  inches  from  its  inferior  extremity,  and  run- 
ning up  to  the  neck  of  the  bone,  lodges  the  teres  minor  muscle ;  a  fossa 


200  SKELETON. 

deeper  than  this,  but  in  front  of  it,  lodges  the  anterior  fasciculus  of  the 
subscapularis  muscle.  On  the  exterior  face  of  the  inferior  angle  is  a 
flat  surface,  from  which  the  teres  major  muscle  and  a  slip  of  the  latis- 
simus  dorsi  arise,  and  at  the  fore  part  of  this  surface  the  inferior  costa 
is  elongated  into  a  kind  of  process.  Just  below  the  glenoid  cavity  is 
a  small  ridge,  for  the  origin  of  the  long  head  of  the  triceps  muscle. 

The  superior  margin  or  costa  of  the  scapula  is  the  shortest  and  thin- 
nest of  the  three,  and  is  terminated  in  front  by  the  coracoid  notch 
between  it  and  the  coracoid  process.  The  notch  is  converted  into  a 
hole  by  a  ligament,  in  the  living  state,  and  through  it  pass  the  supra- 
scapular  nerve  and  blood-vessels. 

The  glenoid  cavity  for  articulating  with  the  os  humeri  supplies  the 
place  of  the  anterior  angle  of  the  scapula.  It  is  very  superficial,  and 
ovoidal,  with  the  small  end  upwards.  Just  at  the  upper  end  is  a  small 
flat  surface,  from  which  the  long  head  of  the  biceps  arises.  The 
glenoid  cavity  is  fixed  on  the  neck  or  cervix,  as  it  is  called,  at  which  a 
general  increase  in  the  thickness  of  the  bone  occurs,  in  order  to  give  a 
strong  foundation  to  this  cavity. 

From  the  superior  part  of  the  cervix  arises  the  coracoid  process,  the 
base  of  it  being  bounded  in  front  by  the  glenoid  cavity,  and  behind  by 
the  coracoid  notch.  The  base  rises  upwards  and  inwards  for  half  an 
inch,  and  what  remains  of  the  process,  then,  runs  horizontally  inwards 
and  forwards,  to  become  smaller,  and  terminate  in  a  point.  This  point 
is  advanced  beyond  the  glenoid  cavity,  about  an  inch  from  its  internal 
margin,  and  is  on  the  same  horizontal  plane  with  the  upper  end  of  the 
glenoid  cavity.  The  upper  surface  of  the  coracoid  process  is  rough 
and  undulated;  below  it  is  concave,  forming  an  arch  under  which  passes 
the  subscapularis  muscle.  On  the  clavicular  side  of  its  base  is  a 
tuberosity,  from  which  arises  the  conoidal  ligament.  The  extremity 
is  marked  by  three  surfaces:  the  interior  is  for  the  insertion  of  the 
pectoralis  minor,  the  middle  for  the  origin  of  the  coraco-brachialis,  and 
the  external  for  that  of  the  short  head  of  the  biceps.  The  acromial 
margin  of  the  coracoid  process  gives  origin  to  the  triangular  ligament 
of  the  scapula,  which  is  inserted  into  the  acromion  just  below  the  face 
for  the  clavicle. 

The  scapula  is  composed  of  cellular  and  compact  substance.  The 
two  laminae  of  the  latter  are  in  contact  in  the  fossa  supra-spinata,  and 
infra-spinata ;  from  which  cause  the  bone  is  diaphanous  at  these  points. 

Of  the  Clavicle  (Clavicula,  Olavicule}. 

The  Clavicle  is  a  long  bone,  situated  transversely  at  the  upper  front 
part  of  the  thorax,  and  extends  from  the  superior  extremity  of  the 
sternum  to  the  acromion  of  the  scapula.  It  is  cylindrical  in  its  middle 
third,  flattened  at  its  external,  and  prismatic  or  triangular  at  its  sternal 
extremity.  Besides  being  shorter,  it  is  more  crooked  and  robust  in 
man  than  in  woman,  and  different  individuals  present  it  under  consi- 
derable varieties  of  curvature.  The  sternal  two-thirds  of  it  are  convex 
in  front,  and  concave  behind,  while  the  humeral  third  is  concave  in 


THE  ARM.  20! 

front,  and  convex  behind:  this  double  curvature  induces  anatomists  to 
compare  it  with  the  letter  S,  though  it  is  by  no  means  so  crooked. 

We  have  to  consider  its  superior  and  inferior  face,  its  anterior  and 
posterior  edge,  and  the  two  extremities.  The  superior  face  is  smooth, 
and  does  not  present  any  marks  of  importance  excepting  a  depression 
near  the  sternum,  for  the  origin  of  the  sterno-cleido-mastoid  muscle. 
The  inferior  face,  near  the  sternal  end,  has  a  rough  surface,  to  which  is 
attached  the  costo-clavicular  or  rhomboid  ligament :  about  fifteen  lines 
from  the  humeral  extremity  is  a  rough  tubercle  for  the  attachment  of 
the  coraco-clavicular  or  conoid  ligament.  Between  the  two  ends,  a 
superficial  fossa  is  extended  for  lodging  the  subclavius  muscle.  The 
sternal  two-thirds  of  the  anterior  margin  are  marked  by  the  origin  of 
the  pectoralis  major ;  it  is  there  thick  ;  the  other  part  of  this  margin  is 

Fig.  56. 


An  anterior  view  of  the  Clavicle  of  the  right  side.— 1.  The  anterior  face  of  the  body  of  the  bone. 
2.  Origin  of  the  clavicular  portion  of  the  sterno-cleido-mastoid  muscle.  3.  The  sternal  extremity  of 
the  bone.  4.  The  acromial  extremity  of  the  bone.  5.  Articular  face  for  the  acromion  process  of  the 
scapula.  6.  Point  of  attachment  of  the  conoid  ligament.  7.  Point  of  attachment  of  the  rhomboid 
ligament. 

thinner  and  gives  origin  to  the  deltoid  muscle.  The  posterior  margin 
presents,  near  its  middle,  one  or  more  foramina  for  the  nutritious  ves- 
sels. The  triangular  internal  end  of  the  clavicle  is  unequal  where  it 
joins  the  sternum,  and  is  elongated  considerably  at  its  posterior  in- 
ferior corner.  The  external  flat  end  presents  at  its  extremity  a  small 
oval  face,  corresponding  with  that  on  the  acromion  scapulae. 

This  bone  is  very  strong  from  the  abundance  of  its  condensed  lamel- 
lated  structure ;  but,  like  other  round  bones,  the  cellular  matter  pre- 
dominates at  its  extremities. 


SECT.  ii. — OF  THE  ARM  (Os  Humeri,  L'Humerus). 

The  arm  extends  from  the  shoulder  to  the  elbow,  and  has  but  one 
bone  in  it,  the  os  humeri.  The  latter,  in  its  general  appearance,  is 
cylindrical,  with  an  enlargement  of  both  extremities ;  the  superior  end 
presents  a  general  swell,  while  the  inferior  is  flattened  out. 

The  superior  extremity  of  the  os  humeri,  which  is  also  called  its  head, 
is  very  regularly  hemispherical,  and  has  its  axis  directed  obliquely  up- 
wards and  backwards,  to  apply  itself  with  more  facility  to  the  glenoid 
cavity  of  the  scapula.  The  base  on  which  the  head  reposes  is  termed 
neck ;  it  is  not  more  than  four  or  five  lines  long,  and  is  marked  off  by  a 
superficial  furrow,  surrounding  the  bone.  This  furrow  is  more  con- 
spicuous above,  where  it  separates  the  head  from  two  knobs,  called  the 
tuberosities. 


202  SKELETON. 

One  of  these  tuberosities,  the  external,  being  placed  beneath  the 
acromion  scapulae,  is  much  larger  than  the  other,  and  bears  on  its  upper 
face  the  marks  of  the  tendinous  insertion  of  three  muscles.  The  most 
internal  mark  is  for  the  supra-spinatus  scapulae;  the  middle  for  the  infra- 
spinatus,  and  the  external,  or  posterior,  for  the  teres  minor.  The 
smaller  tuberosity  is  internal,  and  placed  on  a  line  with  the  coracoid 
process ;  it  has  but  one  mark,  and  that  is  on  its  upper  face,  for  the 
tendinous  insertion  of  the  subscapularis  muscle.  The  two  tuberosities 
are  separated  by  a  deep  fossa,  named  bicipital,  from  its  lodging  the 
tendon  of  the  long  head  of  the  biceps  muscle.  This  fossa  is  continued, 
faintly,  for  some  inches  down  the  os  humeri;  its  lower  part  being 
bounded,  externally,  by  a  rough  ridge,  indicating  the  insertion  of  the 
pectoralis  major,  and  internally  by  another  ridge,  not  quite  so  strong 
or  rough,  indicating  the  insertion  of  the  teres  major  and  latissimus  dorsi. 

Fig.  57. 


An  anterior  view  of  the  Humerus  of  the  right  side.— 1.  The  shaft,  or  diaphysis  of  the  bone.  2.  The 
head.  3.  Anatomical  neck.  4.  Greater  tuberosity.  5.  Lesser  tuberosity.  6.  The  bicipital  groove. 
7.  External  bicipital  ridge,  for  the  insertion  of  the  pectoralis  major.  8.  Internal  bicipital  ridge.  9. 
Point  of  insertion  of  the  deltoid  muscle.  10.  Nutritious  foramen.  11.  Rotula  or  articular  face  for 
the  head  of  the  radius.  12.  Trochlea  or  articular  face  for  the  ulna.  13.  External  condyle.  14.  In- 
ternal condyle.  15,  16.  The  condyloid  ridges.  17.  Lesser  sigmoid  cavity. 

The  body  of  the  os  humeri  is  the  part  extended  between  its  extremi- 
ties. The  superior  half  presents  a  more  cylindrical  appearance  than 
the  inferior,  which  is  rather  triangular.  On  the  middle  of  the  bone, 
externally,  two  inches  below  the  insertion  of  the  pectoralis  major,  exists 
a  triangular  elevation  into  which  the  deltoid  muscle  is  inserted.  At 
the  internal  margin  of  the  bone,  and  on  a  transverse  level  with  this  in- 
sertion, is  the  insertion  of  the  coraco-brachialis  muscle ;  and  between 
the  two  is  the  orifice  of  the  canal  for  the  nutritious  artery.  The  front 
of  the  os  humeri,  in  its  lower  half,  is  flattened  on  each  side  down  to  its 


THE  FORE  ARM.  203 

inferior  end ;  on  these  surfaces  is  placed  the  brachialis  internus  muscle. 
On  a  line  with  the  posterior  end  of  the  greater  tuberosity,  and  a  little 
below  it,  an  elevation  is  formed  for  the  origin  of  the  second  head  of  the 
triceps  extensor  cubiti.  The  posterior  face  of  the  bone  is  flattened  from 
this  point  down  to  its  lower  extremity,  and  accommodates  the  last 
named  muscle. 

The  articular  surface  for  the  elbow  joint  is  very  irregularly  cylin- 
drical. The  part  that  joins  the  radius  presents  itself  as  a  small 
hemispherical  head  (rotula),  placed  on  the  front  of  the  bone,  and  with 
its  axis  looking  forwards.  Just  above  it,  in  front,  is  a  small  depression 
for  the  head  of  the  radius  in  its  flexions.  The  surface  which  articu- 
lates with  the  ulna  (trochlea)  is  more  cylindrical,  but  still  irregularly 
so ;  for  its  middle  is  depressed,  while  the  sides  are  elevated :  the  inter- 
nal side  is  much  broader  and  more  elevated  than  the  external.  The 
lesser  sigmoid  cavity  is  just  above  the  front  of  the  ulnar  articular  sur- 
face, and  receives  the  coronoid  process.  The  greater  sigmoid  cavity  is 
at  a  corresponding  place  behind,  and  receives  the  olecranon  process: 
the  bone  where  it  separates  these  cavities  is  very  thin :  sometimes  it  is 
even  deficient. 

.* 

The  external  condyle  is  just  above  the  radial  articular  surface ;  it 
is  continuous  with  a  ridge  three  or  four  inches  long,  forming  the  exter- 
nal margin  of  the  bone,  and  from  it,  and  the  ridge  together,  arise  the 
extensor  muscles  of  the  fore  arm  and  hand.  The  ridge,  itself,  is 
bounded,  above,  by  a  small  spiral  fossa,  descending  downwards  and 
forwards,  made  by  the  spiral  artery  and  the  muscular  spiral  nerve. 
The  internal  condyle  is  placed  just  above  the  internal  margin  of  the 
ulnar  articular  surface  :  it  is  much  more  prominent  and  distinct  than 
the  external,  and  may  be  readily  felt  beneath  the  skin.  A  ridge  also 
leads  from  it  and  extends  upwards  as  high  as  the  insertion  of  the  coraco- 
brachialis,  but  it  is  by  no  means  so  elevated  as  the  external  ridge, 
though  it  is  much  longer.  From  the  internal  condyle,  and  the  adjoin- 
ing part  of  the  ridge,  arise  the  flexor  muscles  of  the  hand  and  fore  arm. 

The  os  humeri  is  composed  of  compact  and  cellular  substance  ;  the 
latter  predominates  at  the  extremities,  and  the  former  in  the  body. 


SECT.  III. — OF  THE  FORE  ARM. 

The  fore  arm  is  placed  between  the  arm  and  the  hand,  and  consists 
in  two  straight  bones,  the  ulna  and  the  radius,  of  which  the  former  is 
on  the  side  of  the  little  finger,  and  the  latter  on  that  of  the  thumb. 


T 

larg 
fea 


Of  the  Ulna  (Oubitus). 

he  ulna,  though  nearly  straight,  is  not  wholly  so.     It    is  much 
arger  at  the  upper  than  at  the  lower  extremity,  and  in  its  general 
features  is  prismatic..  It  has  to  be  considered  in  its  humeral  and  carpal 
extremities,  and  in  its  body. 


204  SKELETON. 

The  humeral,  or  upper  extremity,  presents  the  olecranon  process 
at  its  termination  ;  the  coronoid  a  little  below  and  in  front ;  the  greater 
sigmoid  cavity  between  the  two  ;  and  the  lesser  sigmoid  on  the  radial 
surface  of  the  coronoid. 

The  olecranon  process  is  rough  on  its  upper  face  posteriorly,  for  the 
insertion  of  the  triceps  muscle,  and  terminates  in  front  in  a  sharp  edge 
and  point,  which  are  received  into  the  greater  sigmoid  cavity  of  the 
os  humeri.  The  coronoid  process  is  a  triangular  sharp  ridge,  much 
elevated,  and  having  a  large  base  ;  on  the  lower  front  of  the  latter  is 
a  roughness  for  the  insertion  of  the  brachialis  internus  muscle.  The 
greater  sigmoid  cavity  forms  all  the  articular  surface  between  the 
margins  of  the  two  processes.  It  is  divided,  transversely,  at  its  bottom, 
by  a  superficial  roughness,  which  distinguishes  the  olecranon  from  the 
coronoid  portion  of  it.  Besides  which,  a  rising  exists  in  its  entire 
vertical  length,  which  is  received  into  the  corresponding  depression  of 
the  os  humeri.  The  lesser  sigmoid  cavity  has  its  surface  continuous 
with  that  of  the  greater,  and  presents  itself  as  a  small  semi-cylindrical 
concavity,  for  articulating  with  the  side  of  the  head  of  the  radius.  A 
small  fossa,  for  fatty  matter  exists  just  above  it,  and  below  it,  is  a 
triangular  excavation  affording  space  for  revolving,  to  the  tubercle  of 
the  radius. 

The  carpal,  or  lower  extremity  of  the  ulna,  presents,  on  the  side  of 
the  little  finger,  a  process  of  variable  length ;  the  styloid,  from  which 
arises  the  internal  lateral  ligament  of  the  wrist.  At  the  radial  side  of 
this  process  is  an  articular  face  or  small  semi-cylindrical  head,  one 
surface  of  which  looks  towards  the  wrist,  and  the  other  is  in  contact 
with  the  radius.  On  the  back  of  the  ulna,  between  the  styloid  process 
and  this  head,  is  a  groove  for  the  passage  of  the  extensor  carpi  ulnaris 
tendon. 

The  body  of  the  ulna  is  prismatic,  in  consequence  of  three  ridges, 
which  extend  from  the  brachial  to  the  carpal  extremity,  and  it  decreases 
very  sensibly  from  above  downwards.  The  first  or  most  prominent  of 
these  ridges  is  on  its  radial  side,  and,  beginning  at  the  posterior  end 
of  the  lesser  sigmoid  cavity,  continues  very  distinct  almost  to  the  lower 
end;  it  then,  however,  gradually  subsides.  From  it  arises  the  interos- 
seous  ligament.  The  supinator  radii  brevis  muscle  also  arises  from  its 
beginning,  for  the  distance  of  a  couple  of  inches.  Within  this  ridge, 
on  the  anterior  or  palmar  face  of  the  bone,  is  a  second,  more  rounded, 
which,  beginning  at  the  internal  margin  of  the  coronoid  process,  extends 
down  to  the  styloid  process.  For  the  greater  part  of  its  length,  it 
gives  origin  to  the  flexor  profundus  digitorum,  but  just  above  the  carpus, 
the  pronator  quadratus  arises  from  it.  The  third  ridge  begins  at  -  the 
external  margin  of  the  olecranon,  and  runs  in  a  serpentine  way  to  the 
inferior  end  of  the  ulna,  but  becomes  almost  indistinct  at  its  lower 
part.  To  the  upper  fourth  of  this  ridge,  is  attached  the  anconeus 
muscle,  which  reposes  in  a  hollow  between  it  and  the  beginning  of  the 
first-mentioned  ridge.  On  the  posterior  surface  of  the  bone,  just  below 


205 


An  external  view  of  the  Ulna  of  the  right  side.  1.  Olecranon  process.  2,  3.  Greater  sigmoid  cavity. 
3.  Coronoid  process.  4.  Lesser  sigmoid  cavity.  5.  External  surface;  just  above  the  number  reposes 
the  anconeus  muscle.  6.  Ridge  for  the  interosseous  ligament.  7.  The  small  head  for  the  radius. 
8.  The  carpal  surface.  9.  The  styloid  process.  10.  Groove  for  the  extensor  carpi  ulnaris  tendon. 

the  olecranon,  is  a  triangular  face  an  inch  and  a-half  or  two  inches 
long  on  which  we  lean,  and  which  is  placed  just  under  the  skin;  it  may, 
therefore,  be  readily  felt  in  the  living  body. 

The  three  ridges  of  the  ulna  divide  it  into  as  many  surfaces  which  are 
each  modified  by  the  muscles  lying  upon  them.  The  anterior  surface 
presents,  just  two  inches  above  the  middle  of  the  bone,  the  canal  for 
the  nutritious  artery,  running  obliquely  upwards. 

The  body  of  the  ulna  is  compact,  the  extremities,  and  more  abund- 
antly the  upper,  are  cellular. 

Of  the  Radius  (Radius). 

The  radius  is  shorter  than  the  ulna,  is  placed  on  its  external  side, 
and  extends  from  the  os  humeri  to  the  wrist.  It  is  smaller  at  the  hu- 
meral than  at  the  carpal  extremity,  and  though  nearly  straight  is  some- 
what arched  outwardly,  which  is  rendered  very  distinct  by  applying 
the  ulnar  margin  of  it  to  a  plane  surface,  and  thus  letting  it  rest  upon 
the  two  ends  of  the  arch.  This  conformation  strengthens  it,  and  mo- 
difies its  range  of  motion  around  the  ulna.  It  is  to  be  considered  in 
its  extremities  and  body. 

The    superior   or   humeral  extremity  presents  a  cylindrical  head, 


206  SKELETON. 

•which 'bears  all  around  it  the  marks  of  a  cartilaginous  incrustation, 
broader  on  the  ulnar  than  on  the  other  side.  The  broader  part  plays 
in  the  lesser  sigmoid  cavity  of  the  ulna,  while  the  other  is  in  contact 
•with  the  annular  ligament.  A  superficial  hollow  also  exists  on  the 
upper  surface  of  this  head,  which  receives  the  convexity  (rotula)  of 
the  articular  face  of  the  external  condyle  of  the  os  humeri.  The  head 
of  the  radius  is  placed  upon  a  narrow  part  called  the  neck,  of  from 
six  to  ten  lines  in  length.  Immediately  below  the  neck,  on  the  ulnar 
side,  is  a  rough  protuberance  or  tubercle,  the  bicipital,  along  the  poste- 
rior half  of  which  is  the  insertion  of  the  biceps  flexor  cubiti. 


An  anterior  view  of  the  Radius  of  the  right  side.  1.  Cylindrical  head.  2.  Surface  for  the  lesser  sig- 
moid cavity  of  the  ulna.  3.  The  neck  of  the  radius.  4.  Its  tubercle,  for  the  insertion  of  the  biceps 
muscle.  5.  Interosseous  ridge.  6.  Concavity  for  the  lower  end  of  the  ulna.  7.  Carpal  surface.  8. 
Styloid  process.  9.  This  number  is  just  above  the  surface  for  the  pronator  quadratus  muscle. 

The  lower  or  carpal  extremity  of  the  bone  is  augmented  considera- 
bly in  volume,  and  is  flattened  out  transversely.  The  carpal  surface 
presents  a  long  superficial  cavity ;  it  is  bounded  externally  by  the  sty- 
loid  process,  from  which  proceeds  the  external  lateral  ligament,  and 
ends  on  its  ulnar  side,  by  a  small  cylindrical  concavity,  for  receiving 
the  lower  end  of  the  ulna.  The  former  or  superficial  cavity  is  divided 
into  two,  by  a  slight  ridge  in  its  short  diameter  ;  the  division  next  the  sty- 
loid  process  receives  the  scaphoid  bone,  and  the  other  the  os  lunare.  At 
this  extremity  also  a  ridge  exists  on  the  front  of  the  bone  for  forming 
the  margin  of  the  articular  face,  and  giving  origin  to  the  capsular  liga- 
ment ;  the  origin  of  the  ligament  being  further  marked,  near  the  sty- 
loid  process,  by  a  deep  triangular  depression,  in  many  subjects.  The 
posterior  and  external  faces  of  the  bone,  here,  are  rendered  irregular 
by  several  grooves  and  ridges.  The  large  groove  next  to  the  cylindri- 
cal concavity  for  the  ulna  transmits  the  tendons  of  the  extensor  com- 


THE  HAND.  207 

munis  digitorum  and  indicator  muscles;  also  the  tendon  of  the  extensor 
major  pollicis,  which  forms  a  channel  somewhat  distinct,  and  on  the 
stjloid  side  of  the  groove.  Next  to  this  is  another  large  groove  for 
the  tendon  of  the  extensor  carpi  radialis  brevior,  and  of  the  longior ; 
and  on  the  styloid  side  of  the  radius  is  the  third  groove  for  transmit- 
ting the  tendon  of  the  extensor  minor  pollicis,  and  of  the  extensor 
ossis  metacarpi  pollicis.  The  anterior  margin  of  this  groove  is  formed 
by  a  small  crista  or  ridge,  into  which  is  inserted  the  tendon  of  the  supi- 
nator  radii  longus. 

.  The  body  of  the  radius  is  somewhat  three-sided,  and  therefore  pre- 
sents three  ridges.  One,  on  its  ulnar  side,  extends  from  the  bicipital 
protuberance  to  the  lower  end,  and  gives  origin  to  the  interosseous 
ligament ;  it  is  sharp  and  well  marked.  Another,  on  the  outer  or  sty- 
loid margin  of  the  bone,  also  begins  at  the  bicipital  protuberance,  and 
terminates  in  the  styloid  process.  The  upper  part  of  this  ridge  is 
curved,  has  the  supinator  radii  brevis  inserted  into  it,  and  a  portion 
of  the  flexor  digitorum  sublimis  arising  from  it ;  at  its  lower  part 
the  pronator  quadratus  is  inserted.  The  third  ridge  is  on  the  poste- 
rior face  of  the  radius,  and  arising  insensibly  from  below  its  neck,  is 
principally  conspicuous  in  the  middle  third  of  the  bone  :  it  runs  down, 
however,  to  the  carpal  extremity,  and,  becoming  more  prominent  there, 
separates  the  two  larger  grooves  from  each  other.  This  ridge  is 
shorter,  and  not  so  elevated  as  the  other  two. 

These  three  ridges  form  as  many  surfaces  to  the  radius,  of  which  the 
anterior,  augmenting  gradually  in  its  descent,  affords  attachment  to 
the  flexor  longus  pollicis  above,  and  to  the  pronator  quadratus  below; 
near  its  middle,  or  somewhat  higher,  is  a  canal,  slanting  upwards,  for 
the  nutritious  artery.  The  posterior  surface  has  the  extensor  muscles 
of  the  thumb  and  the  indicator  lying  upon  it.  The  external  surface 
presents  a  roughness,  just  above  its  middle,  for  the  insertion  of  the 
pronator  teres ;  and  below  it  is  covered  by  the  radial  extensors,  which 
are  crossed  by  the  extensor  metacarpi  and  the  extensor  minor,  pollicis. 
The  body  of  the  radius  is  compact ;  its  extremities  are  cellular. 


SECT.  IV. — OF  THE  HAND. 

The  hand  consists  of  the  carpus,  metacarpus,  and  phalanges,  and 
has  in  its  composition  twenty-seven  bones,  to  which  number  may  be 
added  the  two  sesamoids. 

Of  the  Carpus  (Carpe). 

The  carpus,  or  wrist,  is  next  to  the  bones  of  the  fore  arm.  Eight 
bones  compose  it,  which  are  arranged  into  two  rows,  one  adjoining  the 
fore  arm  and  the  other  the  metacarpus: — they  are  called  first  and 
second  rows.  These  bones  present  very  diversified  forms  and  a  num- 
ber of  articular  faces,  which  render  them  difficult  to  be  distinguished 
from  each  other. 

The  first  or  anti-brachial  row  has  in  it  the  os  scaphoides,  lunare, 


208  SKELETON. 

cuneiforme,  and  pisiforme.     The  second,  or  metacarpal  row,  has  in  it 
the  os  trapezium,  trapezoides,  magnum,  and  unciforme. 


The  two  rows  of  bones  of  the  Carpus,  right  side.  The  upper,  or  first  row,  viewed  on  its  inferior 
articulating  surface.  1.  The  scaphoides.  2  Its  concave  articular  face.  3.  The  lunare.  4.  Its  con- 
cave articular  face.  5  The  cuneiforme.  6.  Its  articular  face.  7.  The  pisiforme.  The  lower,  or 
second  row,  viewed  on  its  superior  articulating  surface.  1.  The  trapezium.  2.  Its  process.  3  An  ar- 
ticular face.  4.  The  articular  face  of  the  trapezoides.  5.  The  posterior  surface  of  the  trapezoides.  6. 
The  magnum.  7.  Its  head,  or  upper  articulating  surface  8.  The  unciforme.  9  Its  hook-like  process. 

Of  the  Scaphoides  (Scaphoide}. 

This  bone  is  on  the  styloid  half  of  the  end  of  the  radius,  and  is  dis- 
tinguishable in  a  set  by  its  greater  length.  It  is  convex  above  and 
concave  below.  The  convexity  forms  only  a  half  of  its  upper  surface, 
and  joins  the  radius ;  the  other  half  is  rough,  and  makes  a  knob  at  its 
extremity.  The  concavity  on  the  lower  surface  is  large  enough  to 
receive  the  end  of  a  finger,  and  joins  the  magnum.  Between  the  con- 
cavity and  the  convexity,  but  on  the  dorsal  surface  of  the  bone,  at  its 
outer  end,  is  a  second  convexity,  of  an  oblong  shape,  for  articulating 
with  the  trapezium  and  trapezoides.  Between  the  two  convexities  is  a 
small  fossa  for  the  capsular  ligament.  The  palmar  or  anterior  face 
shows  a  curve  in  the  bone.  The  knobbed  extremity  projects  beyond 
the  styloid  process  of  the  radius.  The  other  extremity,  which  is 
narrow,  joins  the  os  lunare. 

Of  the  Lunare  (Semilunaire). 

This  bone  is  at  the  ulnar  side  of  the  preceding,  and  may  be  dis- 
tinguished by  the  semi-lunated  shape  of  the  surface  joining  the  sca- 
phoides. Its  upper  surface  is  convex  where  it  articulates  with  the 
radius;  the  lower  face  is  concavely  cylindrical,  to  receive  the  magnum 
and  unciforme.  The  ulnar  side  is  a  plain  surface  which  joins  the  os 
cuneiforme.  Its  dorsal  side  is  rather  thinner  than  its  palmar. 

Of  the  Cuneiforme  or  Pyramidale  (Pyramidal}. 

This  bone  is  united  to  the  ulnar  side  of  the  lunare,  and  may  be  dis- 
tinguished by  its  representing  somewhat  a  triangular  pyramid.  The 
surface  next  the  lunare  is  plain,  but  the  other  extremity,  being  the 
boundary  of  the  wrist  in  that  direction,  is  rough.  Above  it  presents  a 
small  convexity,  adjoining  the  surface  for  the  lunare,  whereby  it  enters 


THE  HAND.  209 

partially  into  the  upper  wrist  joint.  Its  inferior  surface  is  concavo- 
convex,  the  convexity  being  towards  the  ulnar  end.  On  its  palmar 
side  it  presents  a  circular  plain  surface  for  the  os  pisiforme. 

Of  the  Pisiforme  (Pisiforme). 

This  bone  is  placed  on  the  front  or  palmar  surface  of  the  last,  and 
may  be  distinguished  by  its  being  smaller  than  any  other  in  the  carpus, 
by  its  spheroidal  shape,  and  by  its  presenting  but  one  articular  face,  and 
that  corresponds  with  one  on  the  cuneiforme.  It  is  always  so  pro- 
minent as  to  be  felt,  without  difficulty,  at  the  ulnar  extremity  of  the 
wrist,  and  is  very  movable.  Its  inferior  end  is  somewhat  elongated 
towards  the  unciform  process  of  the  unciforme  and  united  to  it  by  liga- 
ment. This  bone  is  in  a  slight  degree  concave  on  the  side  looking  to 
the  radius. 

Of  the  Trapezium  (Trapeze). 

This  bone  is  placed  at  the  radial  end  of  the  second  row;  its  shape  is 
exceedingly  irregular,  but  it  may  be  generally  distinguished  by  being  a 
bone  of  the  third  magnitude  as  regards  the  second  row.  It  is  better 
for  the  student  to  find  out  first  the  surface  by  which  it  articulates  with 
the  metacarpal  bone  of  the  thumb,  which  he  can  do  in  a  short  time  by 
a  comparison  of  the  surfaces  of  the  two  bones.  This  being  successful, 
will  establish  a  clue  to  the  other  surfaces,  and  to  the  relative  position 
of  txhe  bone.  The  thumb  surface  is  a,  concave  cylindrical  trochlea, 
placed  on  the  radial  side  of  the  trapezium,  and  looking  downwards  and 
outwards.  On  the  reversed  or  upper  side  is  a  small  concavity,  which 
receives  the  dorsal  convexity  of  the  scaphoid  bone.  Continuous  with 
this  concavity  is  another  on  the  ulnar  side,  which  receives  a  correspond- 
ing convexity  of  the  trapezoides.  Between  this  concavity  and  the  one 
for  the  thumb  is  a  small  surface,  by  which  the  trapezium  articulates 
partially  with  the  metacarpal  bone  of  the  fore  finger.  The  dorsal  face 
is  rough  and  unequal.  The  palmar  face  is  unequally  divided  by  a  high 
ridge  or  process,  at  the  ulnar  side  of  whose  root  is  a  deep  fossa  for  the 
tendon  of  the  flexor  carpi  radialis. 

Of  the  Trapezoides  (Trapezoide). 

It  is  placed  at  the  ulnar  side  of  the  last  bone,  and  is  the  smallest  in 
the  second  row.  There  is  no  liability  of  confounding  it  with  any  other 
bone  of  the  carpus,  as  it  is  the  least  of  any,  excepting  the  pisiforme. 
The  greater  difficulty  is  the  adjustment  of  it  in  the  separated  bones: 
the  following  rule,  however,  will  serve.  It  is  surrounded  by  articular 
faces  on  its  sides,  but  the  dorsal  surface  presents  a  broad  base,  while 
the  palmar  extremity  is  reduced  in  size.  Holding  the  bone  with  a  re- 
ference to  these,  it  will  be  observed  that  one  side  is  very  crooked  and 
concave,  while  the  reversed  or  opposite  one  is  convex.  The  latter  fits 
against  the  surface  of  the  trapezium  which  has  been  indicated,  while 
the  former  embraces  the  side  of  the  os  magnum  just  below  its  head. 
The  metacarpal  surface  of  the  trapezoides  is  long  and  elevated  in  its 
VOL.  i. — 14 


The  mel 


210  SKELETON. 

middle,  for  being  received  into  the  root  of  the  metacarpal  bone  of  the 
fore  finger,  while  the  upper  surface  presents  a  long  concavity  for  re- 
ceiving a  part  of  the  dorsal  convexity  of  the  scaphoides. 

Of  the,  Magnum  (Grrand  Os}. 

It  is  placed  at  the  ulnar  side  of  the  trapezoides,  and  from  its  being 
larger  than  any  other  bone  in  the  carpus,  will  scarcely  be  mistaken. 
Its  ulnar  side  is  flat,  and  presents  a  plain  surface  for  articulating  with 
the  unciforme.  The  radial  side  is  uneven  and  rather  indistinctly  marked 
where  it  joins  the  trapezoides,  but  the  latter  surface  will  be  found  near 
the  middle  of  this  side  just  below  the  head.  The  upper  surface  of  the 
magnum  is  formed  into  a  hemispherical  head,  the  radial  side  of  which 
reposes  in  the  concavity  of  the  scaphoides,  while  the  ulnar  side 
is  in  the  concavity  of  the  lunare.  Its  metacarpal  surface  is  tri- 
angular, convex,  and  winding,  by  which  it  joins  the  metacarpal  bone 
of  the  middle  finger.  On  the  radial  side  of  this  surface  is  a  small 
one  continuous  with  it,  whereby  the  magnum  articulates  partially  with 
the  metacarpal  bone  of  the  fore  finger.  The  posterior  or  dorsal  face 
is  broad,  while  the  palmar  is  more  narrow. 

Of  the  Unciforme  (Os  CrocTiu). 

It  is  placed  at  the  ulnar  side  of  the  magnum,  is  nearly  of  the  same 
size,  but  readily  distinguishable  from  it  by  its  long  crooked  process  as 
well  as  by  its  peculiar  shape.  Its  radial  side  is  plain  where  it  joins 
the  magnum;  the  reversed  or  ulnar  side  is  brought  to  a  thin  edge. 
The  metacarpal  surface  presents  two  distinct  concavities ;  the  one  next 
to  the  ulnar  edge  is  for  the  metacarpal  bone  of  the  little  finger,  and 
the  other  for  that  of  the  ring  finger.  The  upper  surface  is  convex  and 
winding,  having  its  ulnar  margin  almost  touching  the  surface  for  the 
metacarpal  bone  of  the  little  finger.  The  most  considerable  portion  of 
the  upper  surface  reposes  upon  the  cuneiform,  and  the  remainder  upon 
a  part  of  the  concavity  of  the  lunare.  The  posterior  face  is  broad  and 
rough,  while  the  palmar  is  narrower.  From  the  ulnar  side  of  the  latter, 
projects  the  unciform  process  already  alluded  to. 


The  two  ranges  of  carpal  bones,  thus  shaped,  present,  when  articu- 
lated or  united  together,  an  oblong  body,  the  greatest  diameter  of  which 
is  transverse.  Its  posterior  face  is  semi-cylindrical  and  arched,  while 
the  anterior  face  is  concave  for  the  passing  of  the  flexor  tendons.  Two 
protuberances  are  found  On  each  extremity  of  the  palmar  surface. 
Those  at  the  ulnar  end  are  the  pisiforme,  and  the  unciform  process  of 
the  unciforme ;  those  at  the  radial  end  are  the  protuberance  at  the  ra- 
dial end  of  the  scaphoides,  and. the  sort  of  unciform  process  from  the 
trapezium  bounding  the  radial  margin  of  its  groove.  These  several 
prominences  may,  with  a  little  attention,  be  readily  distinguished 
beneath  the  skin.  The  superior  face  of  the  carpus,  which  articulates 
with  the  lower  end  of  the  radius  and  ulna,  presents  an  oblong  convex 
head  formed  by  the  scaphoides,  the  lunare,  and  very  partially  by  the 


THE  HAND.  211 

cuneiform.  The  inferior  face  of  the  carpus  presents  a  very  diversified 
surface,  subdivided  into  five  distinct  ones,  each  of  which  is  fashioned 
according  to  the  shape  of  the  metacarpal  bone,  with  which  it  has  to 
articulate. 

The  central  joint  of  the  wrist,  formed  between  the  two  rows  of  bones, 
is  very  deserving  of  attention.  The  first  row  is  convex  on  its  radial 
end,  the  convexity  being  formed  on  one  half  of  the  scaphoides ;  to  the 
ulnar  side  of  this  there  is  a  deep  concavity  formed  by  the  other  half  of 
the  scaphoides,  by  the  lunare  and  the  cuneiforme.  The  upper  surface 

Fig.  61. 


A  posterior  view  of  the  articulations  of  the  Bones  of  the  Carpus  in  the  Right  Hand  — 1.  The  ulna. 
2.  The  radius.  3.  Inter-articular  fibre-cartilage.  4.  Metacarpal  bone  of  the  thumb.  5.  Metacarpal 
bone  of  the  first  finger.  6.  Metacarpal  bone  of  the  second  finger.  7.  Metacarpal  bone  of  the  third 
finger.  8.  Metacarpal  bone  of  the  fourth  finger.  S.  The  scaphoides.  L.  The  lunar*.  C.  The  cunei- 
forme. P.  The  pisiforme.  T,  T.  Trapezium  and  trapezoides.  M,  The  magnum,  U.  The  unciforme. 

of  the  second  row  fits  very  accurately  upon  the  lower  surface  of  the 
first.  Its  radial  end  is,  therefore,  a  concavity  formed  by  the  trapezium 
and  trapezoides,  which  receives  the  convexity  of  the  scaphoid ;  then  a 
very  large  prominent  head  is  formed  by  the  magnum  and  unciforme, 
and  received  into  the  concavity  of  the  first  row.  The  magnum  reposes 
upon  the  scaphoides  and  part  of  the  lunare;  the  unciforme  upon  the 
remainder  of  the  lunare,  and  the  whole  of  the  cuneiforme.  The  carpal 
bones  consist  of  cellular  matter  enclosed  by  condensed  lamellated 
substance. 

Of  the  Metacarpus. 

The  metacarpus  is  situated  between  the  carpus  and  the  phalanges  of 
the  fingers  and  thumb.  It  consists  of  five  bones,  one  for  the  thumb  and 
one  for  each  finger.  The  four  latter  are  parallel,  or  nearly  so  with 
each  other ;  but  the  first  diverges  considerably,  and  is  so  placed  as  to 
traverse  the  others  in  front  during  its  motions.  These  bones  are 
rounded  in  their  middle,  are  enlarged  at  their  extremities,  and  are  bent 
so  as  to  be  concave  on  the  anterior  face,  and  project  behind.  Their  sides 
are  impressed  by  the  intervening  muscles.  That  of  the  thumb  is  the 


212  SKELETON. 

shortest,  the  others  decrease  successively  in  length  from  the  fore  to  the 
little  finger. 

Fig.  62. 


An  anterior  view  of  the  Left  Hand.— 1.  The  scaphoides.  2.  The  lunare.  3.  The  cuneiforme.  4.  The 
pisiforme.  5.  The  trapezium.  6.  Groove  for  the  flexor  carpi  radialis  tendon.  7.  The  trapezoides, 
8.  The  magnum.  9.  The  unciforme.  10,  10.  The  five  metacarpal  bones.  11,  11.  First  row  of  pha- 
langes. 12,  12.  Second  row  of  phalanges.  13,  13.  Third  row  of  phalanges.  14.  First  phalanx  of  the 
thumb.  15.  Last  phalanx  of  the  thumb. 

Of  the  First  Metacarpal  Bone,  or  that  of  the  Thumb.— -It  is  placed 
upon  the  trapezium:  and  besides  being  the  shortest,  is  also  the  broadest 
of  any.  Its  upper  end  is  concave  from  side  to  side,  and  raised  in  the 
middle  of  the  articular  face,  to  present  a  fit  surface  to  the  trapezium. 
Its  lower  end  is  semi-cylindrical  and  protuberant,  and  elongated  in  front 
into  a  trochlea,  on  either  side  of  which  reposes  a  sesamoid  bone.  The 
posterior  face  of  its  body  is  flat  and  very  slightly  bent ;  the  anterior 
is  concave  in  its  length,  and  is  divided  into  two  surfaces  by  a  middle 
ridge.  A  roughness  exists  on  either  side,  at  its  lower  end,  for  the  at- 
tachment of  the  lateral  ligament. 

Of  the  Second  Metacarpal  Bone,  or  that  of  the  Fore  Finger. — The 
greater  length  of  this  bone  gives  it  a  distinctive  character.  It  is  placed 
upon  the  trapezoides,  and  articulates  laterally  also  with  the  trapezium 
and  the  magnum.  Its  carpal  or  upper  end  presents,  in  the  middle,  a 
deep  antero-posterior  concavity  for  receiving  the  trapezoides,  at  the  radial 
side  of  which  is  a  small  plain  face  for  articulating  with  the  trapezium, 
and  at  the  ulnar  side  an  oblong  surface,  the  upper  margin  of  which 
joins  the  magnum,  and  the  remainder  is  in  contact  with  the  third  meta- 
carpal bone.  The  lower  end  presents  a  convex  head,  extended  in  front 
to  permit  the  flexion  of  the  finger,  on  each  side  of  which  head  is  a  con- 
cave rough  surface  for  the  lateral  ligament,  it  being  bounded  by  a  flat 
cone  behind.  The  posterior  face  of  the  bone  presents  a  triangular 
flat  surface,  the  base  of  which  is  towards  the  finger  or  phalangial  end. 
The  palmar  face  is  concave,  longitudinally,  and  divided  by  a  middle 
ridge  into  two  surfaces,  each  of  which  is  compressed  by  the  inter- 
osseous  muscles.  A  tubercle  exists  on  the  back  of  the  bone  just  below 


THE  HAND.  213 

its  carpal  end,  for  the  insertion  of  the  tendon  of  the  extensor  carpi 
radialis  longior,  and  another  in  front  for  that  of  the  flexor  carpi 
radialis. 

Of  the,  Third  Metacarpal  Bone. — This  is  a  little  shorter  than  the 
second,  and  is  nearly  of  the  same  size,  but  its  carpal  extremity  is  very 
different.  The  latter  is  triangular,  and  is  bounded  on  its  radial  side 
by  a  sort  of  styloid  process,  with  a  tubercle  on  the  posterior  face  of  it, 
into  which  the  tendon  of  the  extensor  radialis  brevior  is  inserted.  It 
is  placed  upon  the  magnum,  to  which  it  joins  by  a  slightly  concave, 
winding  surface.  It  also  presents,  continuous  with  the  same  surface, 
an  oblong  face  which  joins  the  second  metacarpal  bone,  and,  on  the 
reversed  side,  a  single  long  or  two  round  facets,  which  are  contiguous 
to  the  fourth  metacarpal  bone.  In  regard  to  its  lower  or  phalangial 
extremity  and  body,  this  bone  resembles  closely  the  one  last  described. 

Of  the  Fourth  Metacarpal  Bone. — This  bone  is  placed  upon  the 
unciforme,  but  has  a  very  small  surface  articulating  with  the  magnum. 
It  is  much  smaller  and  shorter  than  the  third  metacarpal,  and  readily 
distinguishable  by  these  circumstances.  The  carpal  surface,  by  which 
it  joins  the  unciforme,  is  triangular  and  slightly  convex;  its  radial 
edge  touches  the  magnum.  Continuous  with  this  edge  are  two  small 
faces,  slightly  convex,  which  join  the  contiguous  faces  of  the  third 
metacarpal  bone.  On  the  reversed  side  of  the  fourth  metacarpal  is  an 
oblong  concave  face  which  joins  the  carpal  end  of  the  fifth  metacarpal 
bone.  In  regard  to  its  body  and  phalangial  extremity,  this  bone  re- 
sembles the  two  preceding,  and  therefore  does  not  require  a  particular 
description. 

Of  the  Fifth  Metacarpal  Bone. — It  is  placed  upon  the  unciforme 
exterior  to  the  last,  and  is  both  smaller  and  shorter  than  the  fourth. 
The  carpal  extremity  presents  a  semi-cylindrical  face,  for  articulating 
with  the  unciforme,  at  the  radial  margin  of  which  is  an  oblong  facet, 
for  joining  the  fourth  metacarpal :  just  below  the  outer  margin  is  a 
small  tuberosity,  into  which  is  inserted  the  tendon  of  the  extensor 
carpi  ulnaris.  The  lower  or  phalangial  extremity,  like  that  of  the 
others,  presents  a  rounded  convex  articular  face,  extended  in  front 
for  the  flexion  of  the  first  phalanx.  The  body  also  corresponds  with 
that  of  the  others,  excepting  that  it  is  more  flat  in  front. 

Of  the  Phalanges. 

The  fingers  (digiti)  are  named  numerically,  beginning  at  the  fore 
finger;  they  are  also  named  from  their  functions,  as  Indicator,  Im- 
pudicus,  Annularis,  and  Auricularis. 

Each  finger  has  three  bones  in  it,  called  its  phalanges:  the  bone 
adjoining  the  metacarpus  is  the  first  phalanx,  the  middle  bone  is  the 
second,  and  the  other  the  third.  (See  Fig.  62.) 

The  first  phalanx  is  the  largest,  and  curved  forwards  on  the  side  of 
prehension,  so  as  to  be  concave  in  front  and  projecting  behind.  Its 


214  SKELETON. 

posterior  faee  is  semi-cylindrical;  the  anterior  face  is  flattened  in  its 
length.  The  two  surfaces  run  into  each  other  by  forming  a  ridge 
on  either  side,  from  which  arises  the  theca  of  the  flexor  tendons. 
The  metacarpal  extremity  is  enlarged,  and  presents  a  superficial 
cavity,  which  receives  the  end  of  the  metacarpal  bone.  On  either 
side  of  this  end  of  the  bone  is  a  small  tuber  for  the  lateral  liga- 
ment. The  lower  extremity  is  also  enlarged  and  flattened  at  its  sides. 
Its  articular  face  is  extended  in  front,  and  presents  two  condyles,  or 
small  heads,  for  joining  the  second  phalanx. 

The  second  phalanx  is  second  in  size  and  length.  It  is  bent  also, 
being  semi-cylindrical  on  its  posterior  face,  flattened  on  its  anterior, 
which  is  somewhat  concave  in  its  length,  and  the  two  faces  form  a 
ridge,  on  either  side,  into  which  the  tendon  of  the  flexor  sublimis  is 
inserted,  and  from  which  arises  the  theca  of  the  flexor  tendons.  Its 
extremities  are  slightly  enlarged :  the  articular  face  of  the  upper 
presents  two  superficial  cavities  for  the  condyles  of  the  first  phalanx: 
the  articular  face  of  the  lower  extremity  presents  a  trochlea,  with  a 
slight  elevation  at  each  side. 

The  third  phalanx  is  the  smallest  of  the  three,  is  straight,  and  is 
very  different  from  the  others.  Its  superior  extremity  being  enlarged, 
presents  an  articular  face,  having  two  superficial  cavities,  which  adjust 
themselves  to  the  corresponding  face  of  the  second  phalanx.  The 
inferior  extremity  is  expanded,  semicircular,  thin,  and  flattened,  its 
margin  and  front  being  very  rough.  -  The  posterior  face  of  the  body 
is  convex.  The  anterior  is  flat,  and  receives  upon  the  front  of  its  base 
the  insertion  of  the  flexor  profundus  tendon. 

The  phalanges  of  the  middle  finger  (Impudicus)  are  larger  and  longer 
than  the  others.  The  phalanges  of  the  fore  finger  (Indicator]  are  next 
in  size,  but  not  in  length,  as  the  ring  finger  is  rather  longer  than  it. 
The  phalanges  of  the  ring  finger  (Annularis)  are  next  in  size,  and 
those  of  the  little  finger  (Auricularis)  the  smallest  and  shortest  of  any. 

The  Thumb  (Pollex)  having  but  two  phalanges,  the  first  corresponds 
sufficiently  in  its  general  form  with  the  first  one  of  the  fingers:  it  may 
be  distinguished,  however,  by  its  shortness  and  additional  size.  The 
second  phalanx  of  the  thumb,  corresponding  with  the  third  of  the 
fingers,  is  only  to  be  distinguished  by  its  additional  bulk  and  length. 

All  the  metacarpal  and  phalangial  bones  have  a  condensed  lamellated 
structure  externally,  and  a  cancellated  one  internally;  and,  like  other 
bones,  are  more  compact  in  their  bodies  than  at  their  extremities. 

There  are  two  small  hemispherical  bones,  called  Sesamoid  ( Ossa  Ses- 
samoidea),  placed  upon  the  trochlea  at  the  lower  extremity  of  the 
metacarpal  bone  of  the  thumb.  They  answer  the  purposes  of  patellae, 
and  facilitate  the  action  of  the  short  flexor  muscle.  The  metacarpal 
bones  of  some  of  the  fingers  are,  in  robust  individuals,  occasionally 
furnished  in  the  same  way. 


DEVELOPMENT  OF  THE  UPPER  EXTREMITIES.         215 


SECT.  V. — OF  THE  DEVELOPMENT  OF  THE  UPPER  EXTREMITIES. 

At  birth,  the  upper  extremities  are  larger  in  proportion  to  the  lower 
than  they  are  at  any  subsequent  period  of  life,  owing,  perhaps,  to  the 
umbilical  arteries,  which  carry  off  to  the  placenta  of  the  mother  the 
greater  part  of  the  blood  which  afterwards  goes  to  the  lower  extremi- 
ties. The  nearer  a  foetus  may  be  to  the  embryo  state,  the  more  marked 
is  this  relative  size  of  the  extremities,  which  becomes  gradually  less 
obvious  till  the  age  of  puberty,  when  it  almost  entirely  disappears. 

At  birth,  the  ends  of  the  clavicles  are,  in  consequence  of  their 
advanced  ossification,  much  less  cartilaginous  than  those  of  the  other 
cylindrical  bones.  Its  shape,  also,  approaches  nearly  to  that  of  the 
adult  state. 

The  scapula  is  also  in  an  advanced  stage  of  ossification  and  large. 
The  glenoid  cavity,  though  still  cartilaginous,  is  well  sustained  by  a 
bony  basement  coming  from  the  central  point  of  ossification  of  the 
scapula,  and  is  much  further  ossified  than  the  acetabulum.  The  acro- 
mion,  the  coracoid  process,  and  the  angles  are  still  cartilaginous. 

The  os  humeri  is  cartilaginous  at  both  extremities,  which  are  also 
larger,  proportionally,  in  consequence  of  this  state.  Its  inferior  ex- 
tremity is  remarkable  for  the  size  of  that  portion  of  it  which  articulates 
with  the  radius. 

In  the  fore  arm,  the  extremities  of  its  bones  are  cartilaginous.  The 
ulna  has  the  olecranon  large,  while  its  coronoid  process  is  compara- 
tively small;  the  greater  sigmoid  cavity  is,  consequently,  not  so  con- 
cave as  in  the  adult.  The  position  of  the  radius,  at  its  upper  end,  is 
somewhat  peculiar,  for  it  is  much  more  anterior  than  in  the  adult;  a 
circumstance  depending  upon  the  greater  size  of  the  rotula  of  the 
humerus,  upon  which  it  rests.  This  arrangement  renders  pronation 
more  extended  in  the  foetus,  as  the  radius  always  crosses  the  ulna  with 
additional  facility,  by  being  placed  more  anterior  to  it.  This  fact  is 
strongly  exemplified  in  the  bones  of  the  fore  extremity  of  animals. 
Bichat  observes  that  this  greater  extent  of  pronation  exposes  the  annular 
ligament  to  being  stretched  considerably  behind,  and,  consequently,  the 
radius  to  luxations  at  its  head ;  an  accident  by  no  means  unfrequent 
among  children.  The  late  Dr.  Physick  says  that  he  has  often  seen  it 
in  consequence  of  nurses  incautiously  seizing  them  by  the  fore  arm  to 
help  them  over  gutters,  or  to  render  them  other  assistance.  It  happens 
while  the  arm  is  in  a  state  of  pronation;  for  the  weight  of  the  body, 
by  hanging  from  it,  increases  the  position,  distends  the  ligaments,  and 
produces  luxation.  As  the  bones  of  the  fore  arm  in  the  foetus  are 
nearly  straight,  the  interosseous  space  decreases  gradually  from  above 
downwards. 

The  carpus  is  entirely  cartilaginous  at  birth,  and  consists  in  the 
same  number  of  pieces  that  it  does  in  the  adult.  Its  articular  cavities 
are  well  formed.  Its  size  is  proportionate  to  what  it  is  in  the  adult. 
In  this  respect  it  differs  from  the  cartilaginous  extremities  of  the  round 
bones,  which  are  always  larger  from  being  in  this  state.  The  carpus, 
therefore,  appears  small  in  the  foetus. 


216  SKELETON. 

The  metacarpus  is  cartilaginous  at  its  extremities,  but  ossified  in  the 
middle.     The  phalanges  are  in  the  same  state. 


SECT.  VI. — OF  THE  MECHANISM  OF  THE  UPPER  EXTREMITIES. 

The  scapula  and  clavicle  are  for  the  superior  extremity  what  the  os 
innominatum  is  for  the  inferior  ;  in  consequence  of  which,  some  anato- 
mists consider  them  as  a  part  of  the  trunk  of  the  body.  Though  the 
convenience  of  anatomical  description  generally  requires  them  to  be 
associated  with  the  upper  extremity,  I  shall  depart  from  the  rule  on  the 
present  occasion,  and  view  them  only  as  the  basis  of  the  attachments 
arid  motions  of  the  os  humeri,  and  of  the  remaining  parts  of  the  supe- 
rior extremity. 

The  upper  extremities,  considering  them  as  commencing  with  the  os 
humeri,  differ  materially  in  their  position  from  the  lower.  They  are 
placed  much  farther  behind  ;  of  which  one  may  be  satisfied  fully  by 
drawing  a  line  from  the  middle  of  the  glenoid  cavity  to  the  middle  of 
the  acetabulum  of  the  same  side  ;  the  body  being  perfectly  erect  at  the 
time,  the  line  will  be  found  oblique.  The  advantage  of  this  arrange- 
ment is  to  give  greater  latitude  of  motion  to  the  upper  extremity  than 
if  it  had  been  ^placed  more  in  front.  Another  important  benefit  is, 
that  by  the  bulk  of  the  shoulder  being  placed  behind  the  centre  of 
gravity,  the  erect  position  is  more  easily  preserved  ;  a  different  position 
of  it,  by  throwing  its  weight  forwards,  would  have  had  a  continual  tend- 
ency to  produce  falls,  and  to  effect  somewhat,  in  man,  the  same  incon- 
venience which  is  felt  by  the  quadruped  in  the  erect  position.  Another 
point,  also  of  some  interest  in  the  position  of  the  upper  extremities,  is 
the  distance  to  which  they  are  separated  from  each  other  by  the  lateral 
projection  of  the  scapulae,  and,  consequently,  of  the  glenoid  cavities, 
a  distance  owing  to  the  length  of  the  clavicles,  and  which  considerably 
exceeds  the  distance  between  the  heads  of  the  ossa  femorum. 

When  the  whole  length  of  the  superior  is  compared  with  that  of  the 
inferior  extremities,  the  difference  is  not  so  great  as  one  may  suppose. 
The  former  is  ascertained  by  a  line  drawn  from  the  head  of  the  os 
humeri  to  the  end  of  the  middle  finger :  as  the  hand  is  parallel  with 
the  bones  of  the  fore  arm,  its  length  is  also  included,  which  amounts 
to  a  considerable  portion  of  the  whole.  On  the  contrary,  from  the 
foot  being  articulated  at  right  angles  with  the  leg,  only  its  thickness 
contributes  to  the  length  of  the  lower  extremity.  As  far,  however,  as 
individual  bones  are  concerned,  those  of  the  upper  extremity,  with  the 
exception  of  its  phalanges,  are  uniformly  shorter  than  the  corresponding 
bones  of  the  lower  extremity.  The  os  humeri  is  much  shorter  than  the 
os  femoris — the  bones  of  the  fore  arm  than  the  bones  of  the  leg — the 
carpal  and  metacarpal  bones  than  the  tarsal  and  metatarsal. 

The  bones  of  the  upper  extremity  are  much  less  robust  than  those  of 
the  lower,  a  very  certain  indication  of  th6  difference  of  the  uses  for 
which  they  were  intended.  Their  articular  surfaces  are  arranged  for 
great  variety  and  extent  of  motion,  in  the  seizing  and  handling  of 
bodies ;  whereas  in  the  lower  extremity,  they  are  fashioned  so  as  to  suit 
the  comparatively  limited  number  of  motions  requisite  for  progression, 


MECHANISM  OF  THE  UPPER  EXTREMITIES.  217 

and  to  sustain  the  body  firmly  in  the  upright  position.  The  carpus 
and  metacarpus  are  much  smaller  than  the  tarsus  and  the  metatarsus, 
because  the  latter  are  intended  to  support  a  great  weight.  On  the 
contrary  the  phalanges  of  the  fingers  are  much  better  developed  than 
the  phalanges  of  the  toes,  because  the  latter  are  not  destined  to  hold 
bodies  and  to  examine  them,  and  may  be  dispensed  with,  both  in  stand- 
ing and  in  progression. 

The  motions  of  the  upper  extremity  are  immensely  varied,  and  by  a 
short  attention  to  them,  some  useful  hints  may  be  obtained  in  regard  to 
dislocations. 


SECT.  VII. — OF  THE  MOTIONS  OF  THE  SHOULDER. 

The  clavicle  performs  a  very  important  office  in  the  actions  of  the 
shoulder,  by  preserving  it  in  a  fit  attitude  for  the  motions  of  the  upper 
extremity.  The  simple  movements  of  the  clavicle,  of  which  the  sterno- 
clavicular  articulation  is  the  centre,  are  those  of  elevation,  depression, 
advancing,  and  retreating,  and  a  rapid  succession  of  these  produces 
circumduction.  The  weight  of  the  shoulder  is  also  sustained  by  the 
clavicle,  by  the  latter  being  fastened  at  the  extremity  next  to  the  ster- 
num, and  having  in  the  cartilage  of  the  first  rib  a  fulcrum,  interme- 
diate to  this  attachment  and  to  the  weight  at  its  other  end.  This  is 
proved  conclusively  by  its  fracture ;  for  in  that  case  the  shoulder  inva- 
riably falls  down,  from  the  lever  being  broken  which  kept  it  up. 

The  clavicle,  also,  by  keeping  the  glenoid  cavity  at  a  distance  from 
the  side  of  the  thorax,  and  directed  outwards,  gives  great  facility  and 
latitude  to  certain  motions  in  the  human  subject ;  and  which  are  per- 
formed with  difficulty,  and  very  imperfectly,  in  animals  not  having  a 
clavicle.  A  principal  one  of  these  motions  is  circumduction,  manifested 
by  the  elbow  being  turned  inwards  or  outwards,  and  in  most  persons 
extends  to  three-fourths  or  even  an  entire  circle.  This  motion  concurs 
in  the  action  which  brings  the  hand  to  the  mouth,  in  consequence  of 
which  such  an  action  is  performed  with  difficulty  when  the  clavicle  is 
broken.  After  an  accident  of  the  kind,  the  head,  instead  of  remaining 
stationary  as  usual,  is  advanced  towards  the  hand,  without  which  the 
act  cannot  be  accomplished.  A  certain  length  in  the  clavicle  seems 
indispensable  to  the  vigorous  and  perfect  action  of  the  shoulder  in  par- 
ticular movements  ;  if  the  clavicle  be  disproportionately  long,  as  in 
females,  these  movements  are  executed  with  inevitable  awkwardness 
and  imbecility ;  as,  for  example,  in  their  throwing  a  stone. 

The  scapula  presents  a  movable  basis,  on  which  the  motions  of  the 
arm  are  accomplished.  Its  primary  motions  are  such  as  have  been 
assigned  to  the  clavicle,  in  consequence  of  the  connection  between  these 
bones  ;  besides  which,  in  all  the  extreme  motions  of  the  humerus,  back- 
wards or  forwards,  the  scapula  is  caused  to  perform  a  partial  rotation, 
the  axis  of  which  is  indicated  by  a  line  drawn  from  the  end  of  the 
acromion  to  the  inferior  angle.  When  the  arm  is  brought  very  far 
forwards,  the  inferior  angle  of  the  scapula  is  carried  outwards,  and 
somewhat  elevated,  while  the  superior  angle  is  directed  towards  the 


218  SKELETON. 

spine,  and  somewhat  depressed.  .But  when  the  arm  is  carried  very  far 
backwards,  the  inferior  angle  is  directed  towards  the  spine,  and  the 
superior  angle  looks  forwards  and  upwards.  The  clavicle  in  these 
cases  moves  inconsiderably,  as  the  scapula  enjoys  a  pendulous  motion, 
and  its  point  of  suspension  is  the  outer  end  of  the  clavicle  ;  at  which 
place  the  oblong  articular  surfaces  slide  laterally  upon  each  other  and 
decussate.  The  extreme  degrees  of  these  motions  tend  to  dislocate  this 
articulation,  but  the  accident  is  prevented  by  the  strong  coraco-clavi- 
cular  ligament,  which,  by  its  peculiar  position  and  conformation,  resists 
firmly  at  a  certain  point.  In  the  abduction  and  adduction  of  the  arm, 
the  scapula  is  motionless. 


SECT.  VIII. — OF  THE  MOTIONS  OF  THE  SHOULDER  JOINT. 

The  os  humeri  is  susceptible  of  elevation,  depression,  advancing,  re- 
treating, circumduction,  and  rotation. 

In  elevation,  the  head  of  the  os  humeri  slides  downwards  in  the 
glenoid  cavity,  and  distends  the  lower  part  of  the  capsular  ligament. 
In  this  motion  the  scapula  is  apt  to  follow  it ;  in  which  case  there  will 
be  a  less  degree  of  distension  in  the  capsular  ligament.  If  the  os 
humeri  be  carried  forwards,  its  elevation  is  performed  with  much  more 
ease,  from  the  readiness  with  which  the  scapula  follows  it ;  but  if  it  be 
carried  backwards,  this  facility  is  much  diminished.  It  is  hi  the  latter 
position,  therefore,  that  dislocations  downwards  are  most  disposed  to 
occur  when  violence  is  offered  to  the  joint.  If  in  every  case  the  scapula 
could  follow  the  motions  of  the  os  humeri,  so  as  to  present  fairly  its 
glenoid  cavity,  luxations  would  be  comparatively  rare ;  but  generally 
the  violence  offered  transmits  its  momentum  so  speedily  to  the  joint, 
that  the  muscles  of  the  scapula  are  taken  by  surprise,  and  have  not 
time  to  adjust  properly  the  glenoid  cavity. 

In  the  depression  of  the  os  humeri,  the  parts  constituting  the  shoul- 
der joint  are  in  their  most  natural  and  easy  position.  The  capsular 
ligament  becomes  very  loose  below,  and  is  somewhat  stretched  above. 
Any  degree  of  force  which  might  be  applied  to  the  member  is  warded 
off  and  its  direction  changed  by  the  intervention  of  the  trunk  of  the 
body.  Should,  however,  the  force  be  applied  directly  in  the  axis  of 
the  bone,  the  projection  of  the  acromion  process,  and  the  strength  of 
the  triangular  ligament  of  the  scapula,  would  arrest  the  dislocation. 

When  the  os  humeri  is  advanced,  the  posterior  part  of  the  capsular 
ligament  is -put  upon  the  stretch  ;  but  the  form  and  arrangement  of  the 
articular  surfaces  are  somewhat  favorable  to  this  position,  and  accord- 
ingly it  is  one  of  but  little  inconvenience.  When  the  os  humeri  is 
retracted,  its  head,  by  being  directed  forwards,  exercises  considerable 
force  upon  the  fore  part  of  the  capsular  ligament,  and  when  assisted  by 
an  external  momentum  is  disposed  to  dislocation  forwards  and  inwards. 

The  motion  of  circumduction  is  very  extensive  in  the  shoulder  joint ; 
and  by  it  the  os  humeri  describes  a  cone,  of  which  the  glenoid  cavity  is 
the  apex.  It  is  a  regular  succession  of  the  movements  already  mentioned, 
and  in  consequence  of  all  the  motions  forwards  of  the  os  humeri  being 


MOTIONS  OF  THE  FORE  ARM.  219 

more  easy  and  natural,  the  axis  of  the  cone  instead  of  being  directly 
outwards,  is  somewhat  forwards. 

By  rotation,  is  meant  the  revolving  of  the  os  humeri  upon  itself. 
The  centre  of  this  movement  is  not  the  axis  of  the  bone,  but  is  removed 
to  one  side  of  it,  by  the  lateral  projection  of  the  head.  The  neck, 
however,  is  too  short  and  thick  to  permit  any  great  extent  to  this 
motion ;  it,  accordingly,  is  limited  in  such  a  way  as  never  to  amount 
to  luxation.  Its  greatest  extent,  in  most  persons,  does  not  exceed  the 
describing  of  half  a  circle,  which  may  be  ascertained  by  applying  a 
finger  upon  the  internal  condyle  of  the  os  humeri.  By  it  the  capsular 
ligament  is  rendered,  alternately,  loose  and  tense  on  its  front  and  back 
parts.  Bichat  observes,  that  in  the  anchylosis  of  the  elbow  joint,  this 
motion,  by  habit,  is  much  augmented,  so  as  to  supply  the  want  of  rota- 
tion of  the  head  of  the  radius  upon  the  ulna.  The  scapula  and  the 
clavicle  do  not  vary  their  position  in  rotation. 


SECT.  IX. — OF  THE  MOTIONS  OF  THE  FORE  ARM. 

There  are  two  kinds  of  motion  in  the  fore  arm.  In  the  one,  the 
fore  arm  is  flexed,  and  extended  upon  the  arm ;  and  in  the  other,  the 
radius  only  changes  its  position  in  regard  to  the  ulna. 

1.  The  ulna  is  the  essential  agent  of  the  first,  in  consequence  of  its 
manner  of  articulation  with  the  os  humeri ;  the  radius  is  only  acces- 
sory, and  is  drawn  by  the  ulna  into  a  participation  in  its  motions. 
These  two  bones,  it  will  be  recollected,  are  disposed  of  in  an  inverse 
manner,  the  larger  part  of  the  ulna  being  above,  while  the  larger  part 
of  the  radius  is  below.  This  arrangement  causes  the  ulna  to  present 
the  principal  articular  surface  for  union  with  the  os  humeri,  while  the 
radius  affords  the  principal  surface  to  the  carpus  ;  it  also  gives  to  the 
whole  fore  arm  a  great  uniformity  in  its  transverse  diameter.  The 
fore  arm  executes,  upon  the  arm,  flexion,  extension,  and  lateral 
inclination. 

Where  the  flexion  is  complete,  the  coronoid  process  is  received  into 
its  cavity,  on  the  front  of  the  os  humeri ;  and  the  olecranon,  having 
left  its  cavity,  is  placed  below  the  condyles.  In  this  state  the  capsular 
ligament  is  stretched  at  its  posterior  part,  while  the  anterior  is  thrown 
into  folds,  and  is  relaxed  along  with  the  lateral  ligaments.  In  the 
demi-flexion  of  the  arm,  there  is  a  more  equal  degree  of  tension  of  the 
several  ligaments.  When  the  os  humeri  is  reposing  in  its  most  easy 
attitude,  at  the  side  of  the  body,  if  the  fore  arm  be  flexed,  its  line  of 
motion  directs  the  hand  towards  the  mouth  ;  a  circumstance  which  is 
accounted  for  by  the  peculiar  obliquity  of  the  trochlea,  on  the  lower 
part  of  the  os  humeri,  upon  which  the  ulna  revolves,  and  is  inde- 
pendent of  any  special  act  of  volition.  It  is  said  that  man,  above  all 
other  animals,  has  the  mechanism  of  the  upper  extremity  most  parti- 
cularly addressed  to  the  latter  motion,  to  the  perfection  of  which  the 
clavicle  is  indispensable.  It  is  in  consequence  of  this  application  of 
the  clavicle  that,  if  it  be  broken,  man,  like  animals  which  are  entirely 
deprived  of  it,  will,  in  the  flexions  of  the  fore  arm,  more  easily  carry 
the  hand  to  the  opposite  shoulder  than  to  the  mouth. 


220  SKELETON. 

In  the  full  extension  of  the  fore  arm,  the  olecranon  process,  being 
received  into  its  cavity,  is  much  above  the  condyles  of  the  os  humeri. 
The  lateral  ligaments,  as  well  as  that  part  of  the  capsule  on  the  front 
of  the  joint,  are  in  a  state  of  tension.  When  the  extremity  is  in  this 
position,  a  fall  upon  the  hand  may  produce  a  dislocation  backwards. 
In  this  case  the  fore  arm  being  fixed,  the  coronoid  process  affords  the 
surface  upon  which  the  principal  momentum  of  the  fall  is  felt.  If  the 
ligaments  on  the  front  of  the  joint  be  not  strong  enough  to  withstand 
the  force,  they  are  laceratedj  and  the  articular  surfaces,  passing  each 
other,  the  upper  parts  of  the  ulna  and  radius  are  driven  behind  the  os 
humeri.  Bichat  asserts,  that  nothing  is  more  easy  than  to  produce 
such  a  luxation  on  the  dead -body  by  a  similar  proceeding,  and  that  he 
has  repeatedly  done  it — that  it  is  about  as  easy  to  produce  this  disloca- 
tion, as  it  is  difficult  to  effect  one  at  the  scapulo-humeral  articulation. 
In  a  moderate  extension  of  the  fore  arm,  produced  by  a  small  weight 
suspended  on  the  hand  at  arm's  length,  there  is  a  well-marked  pressure 
of  the  inferior  extremity  of  the  os  humeri  against  the  ligaments  in  front 
of  the  articulation,  which  is  augmented  by  a  tendency  of  the  ulna  to 
describe  the  arc  of  a  circle,  from  above  downwards,  and  to  separate 
itself  from  the  os  humeri.  In  this  case  the  muscles  which  flex  the 
fore  arm  are  kept  so  much  in  the  line  in  which  they  contract,  or  are  so 
little  removed  from  the  axis  of  their  own  motion,  that  they  contribute 
but  little  to  sustain  the  fore  arm  in  situ ;  the  weight  is,  therefore, 
actually  sustained  by  the  ligaments  in  front  of  the  articulation.  But 
they  being  pressed  and  drawn  in  the  manner  mentioned,  such  great 
pain  and  weariness  are  produced  as  to  render  a  continued  suspension 
of  the  weight  insupportable;  the  experimenter  is,  therefore,  in  a  short 
time,  under  the  necessity  either  of  casting  off  the  weight  or  of  giving 
such  a  degree  of  flexion  to  the  fore  arm  as  will  allow  the  muscles  to 
contract  more  advantageously. 

Besides  flexion  and  extension,  the  ulna  has  a  sort  of  rocking  motion 
when  the  fore  arm  is  only  half  bent ;  but  when  the  latter  is  at  either 
extreme  of  the  former  positions,  this  motion  is  imperceptible,  owing  to 
the  nature  of  the  articular  surfaces  and  the  resistance  of  the  ligaments. 

2.  In  the  rotations  of  the  radius  upon  the  ulna,  the  latter  is  almost 
motionless,  excepting  the  case  specified  in  the  last  paragraph.  The 
position  of  the  radius  on  a  plane  somewhat  anterior  to  the  ulna,  its 
small  cylindrical  upper  extremity,  and  its  broad  lower  one,  all  concur 
in  facilitating  rotations  forwards  and  backwards.  It  is  owing  to  the 
hand  following  these  motions  that  the  first  is  expressed  by  the  term 
pronation,  in  which  the  palm  of  the  hand  is  directed  downwards ;  and 
the  second,  supination,  in  which  the  palm  is  upwards  and  the  back  of 
the  hand  downwards. 

Pronation  is  the  most  common,  and,  consequently,  the  easiest  posi- 
tion to  the  fore  arm,  when  not  carried  to  an  extreme :  it  is  adopted 
involuntarily,  simply  by  the  action  of  the  ligaments  and  the  particular 
shape  of  the  articulating  surfaces  of  the  bones.  It  is  the  posture  most 
generally  suited  to  the  examination  and  grasping  of  surrounding  bodies. 
In  order  that  it  may  be  accomplished  fully,  the  superior  extremity  of 
the  radius  rolls  on  its  own  axis,  in  the  loop  formed  by  the  annular 


MOTIONS  OF  THE  HAND.  221 

ligament  and  the  lesser  sigmoid  cavity  of  the  ulna ;  while  the  lower 
extremity  revolves  around  the  little  head  of  the  ulna  below.  The 
middle  part  of  the  radius  crosses  that  of  the  ulna,  and  the  interosseous 
space  is  diminished.  An  excess  of  this  motion  will  produce  luxation 
either  above  or  below,  but  more  easily  at  the  latter  place ;  both  on 
account  of  the  greater  extent  of  motion  there,  and  of  the  comparative 
weakness  of  the  ligaments. 

In  supination,  a  movement  the  reverse  of  what  is  described  takes 
place ;  the  radius  revolves  outwardly,  and  is  brought  parallel  with  the 
ulna.  If  by  any  force  it  be  carried  beyond  this  line,  a  dislocation  may 
occur,  in  which  the  little  head  of  the  ulna,  abandoning  the  sigmoid 
cavity  of  the  radius,  will  be  thrown  in  front  of  it.  An  accident,  how- 
ever, said  to  be  very  unusual. 

Bichat  considers  the  cartilage  between  the  ulna  and  the  cuneiforme 
as  a  principal  obstacle  to  these  luxations ;  but  when  it  is  insulated  or 
separated  from  the  cartilage  of  the  radius,  as  sometimes  occurs,  the 
joint  is  very  much  weakened  thereby,  and  more  exposed  to  dislocations. 


SECT.  X. — OF  THE  MOTIONS  OF  THE  HAND. 

The  hand,  as  a  whole,  performs  upon  the  fore-arm  flexion,  extension, 
lateral  inclination,  and  circumduction.  As  it  only  follows  the  motion 
of  the  radius  in  pronation  and  supination,  and  does  not  contribute  in 
the  slightest  degree  to  either,  its  appropriate  motions  can  all  be  per- 
formed independently  of  them. 

In  flexion  the  convex  head,  formed  by  the  first  range  of  carpal  bones, 
slides  from  before  backwards  in  the  concavity  which  receives  it.  The 
posterior  part  of  the  capsular  ligament  is  stretched,  and  the  anterior 
thrown  into  folds,  while  the  lateral  ligaments  remain  at  their  ease.  In 
extension,  with  the  exception  of  the  lateral  ligaments,  the  phenomena 
are  reversed.  This  extension,  as  is  well  known,  not  only  brings  the 
hand  into  the  same  line  with  the  bones  of  the  fore  arm,  but  carries  it 
beyond  that  line  till  it  forms  almost  a  right  angle  with  it.  The  wrist 
joint,  in  this  respect,  differs  from  the  other  ginglymous  articulations; 
but  what  it  gains  in  extension  it  loses  in  flexion,  as  it  cannot  be  bent 
so  much  as  either  the  elbow  or  knee.  The  arrangement,  however,  gives 
great  facility  to  the  use  of  the  hand. 

In  the  lateral  inclinations  of  the  hand,  the  capsule  in  front  of  and 
behind  the  wrist  is  but  little  affected ;  but  the  lateral  ligaments  are 
alternately  relaxed  and  tightened.  As  the  articular  surfaces  are  ex- 
tensive in  the  line  of  these  motions,  dislocations  in  the  direction  of  either 
of  them  are  very  uncommon,  and  when  they  do  occur  they  are  for  the 
most  part  incomplete. 

Circumduction  is  produced  by  a  regular  succession  of  the  motions 
described;  it,  therefore,  does  not  require  a  specific  notice. 

Of  the  Partial  Motions  of  the,  Hand. — Well  marked  changes  of 
position  occur  between  the  first  and  second  rows  of  the  carpus ;  these 
are  principally  flexion  and  extension.  Lateral  inclination  or  abduction 
and  adduction  are  extremely  limited,  and  circumduction  does  not  exist. 


222  SKELETON. 

The  motions,  such  as  they  are,  are  confined  within  much  narrower 
limits  than  those  of  the  radio-carpal  articulation,  and  have  for  their 
main  fulcrum  the  head  of  the  magnum. 

The  lateral  articular  surfaces  of  the  several  bones  of  the  carpus, 
though  they  present  the  arrangement  of  joints,  have  not  an  appreciable 
motion  upon  each  other.  Whatever  changes  of  position  happen  among 
them,  are  probably  so  obscure  that  they  never  appear,  except  under  the 
influence  of  great  and  sudden  violence.  The  complexity  of  the  me- 
chanism of  the  wrist  seems  to  have  a  double  object  in  view ;  for  ordinary 
circumstances  of  impulse  and  motion,  the  flexion  and  extension  of  the 
first  row  upon  the  second,  as  a  whole,  is  sufficient;  but  when  a  great  mo- 
mentum is  communicated  to  the  structure,  the  number  of  pieces  which 
form  it,  and  the  variety  of  their  shapes  and  mode  of  attachment,  diffuse 
the  violence  throughout  the  whole  wrist,  and  generally  save  it  from 
dislocation  or  fracture.  The 'fracture  of  a  single  bone,  excepting  from 
gun-shot  wounds,  is  a  very  unusual  circumstance.  I  have  had,  however, 
in  possession  a  scaphoides  which  was  broken  through  transversely,  and 
had  probably  been  in  that  state  for  a  long  time,  as  all  appearance  of 
inflammation,  at  the  period  of  my  finding  it,  was  absent,  and  as  the 
fractured  surfaces  had  become  highly  polished  by  rubbing  against  one 
another. 

The  pisiform  bone  moves  with  much  freed'om  inwardly  and  outwardly 
on  the  cuneiform,  but  its  motion  up  and  down  is  resisted  by  the  muscles 
which  are  attached  to  it.  Owing  to  its  articular  cavity  being  insulated, 
and  to  its  own  remoteness,  a  dislocation  of  it,  if  it  did  occur,  would 
interfere  but  little  with  the  general  uses  of  the  hand. 

The  metacarpal  bone  of  the  thumb  has  a  very  free  motion  on  the 
trapezium  in  flexion,  extension,  adduction,  abduction,  and  circumduc- 
tion  as  the  result  of  the  other  four.  In  consequence  of  this  variety  of 
movement  in  it,  of  its  position  on  a  plane  anterior  to  that  of  the  fingers, 
and  of  a  corresponding  obliquity  of  the  trapezium,  the  thumb  can,  in 
all  cases  of  grasping  and  examining  bodies,  antagonize  the  fingers. 
The  circumduction  of  the  thumb  resembles  very  much  that  of  the  wrist, 
or  shoulder  joint,  though  the  mechanism  of  the  articular  surfaces  is 
different.  In  this  motion  it  describes  a  cone  or  circle,  the  anterior 
segment  of  which  is  larger,  and  performed  with  more  facility  than  the 
posterior. 

The  second  and  third  metacarpal  bones  are  so  closely  bound  to  the 
carpus  that  their  motion  above  is  almost  imperceptible ;  in  consequence 
of  their  length,  the  motion  is  more  appreciable  below,  but  even  there 
it  is  very  much  restricted.  The  fourth  metacarpal  bone  has  a  limited 
ginglymous  movement,  which  is  sufficiently  demonstrable,  and  the  fifth 
has  it  in  a  considerable  degree ;  it  also  admits  of  a  sort  of  adduction, 
by  which  it  is  brought  nearer  to  the  other  bone. 

The  first  phalanges  admit  of  flexion,  extension,  adduction,  abduction, 
and  circumduction  by  the  successive  performance  of  the  others.  The 
first  phalanx  of  the  thumb  has  the  three  last  motions  very  much  cur- 
tailed, in  consequence  of  the  necessity  of  great  strength  and  stability 
in  this  joint,  so  as  to  antagonize  firmly  the  fingers.  The  remaining 


THIGH  BONE.  223 

phalanges  perform  simply  flexion  and  extension.  The  latter,  as  in  the 
knee  and  elbow,  rarely  goes  beyond  the  'axis  of  the  limb,  whereas  the 
former,  from  the  extent  of  the  articular  surfaces  and  the  particular 
mechanism  of  the  joint,  permits  the  hand  to  be  closed  and  doubled. 

From  what  has  been  said  it  will  not  be  difficult  to  form  a  general 
conception  of  the  great  variety  of  motions  resulting  from  the  number 
and  arrangement  of  the  pieces  constituting  the  upper  extremity.  The 
os  humeri  being  the  basis  of  them,  may  be  presented  in  any  direction ; 
the  bones  of  the  fore  arm  may  be  alternately  retracted  or  protruded, 
and  by  the  revolving  of  the  radius  will  permit  the  palm  of  the  hand  to 
apply  itself  at  any  point ;  and  again,  the  multiplicity  of  simple  motions 
of  the  hand  and  the  exhaustless  variety  of  their  compounds,  contribute 
to  give  to  the  upper  extremity  in  man  a  perfection  of  mechanism  in- 
finitely beyond  anything  which  can  be  devised  by  the  powers  of  art,  a 
sentiment  cogently  expressed  by  the  late  Professor  Wistar,  who  re- 
marked that  "  The  human  hand,  directed  by  the  human  mind,  is  the 
most  perfect  instrument  that  man  ever  saw,  or  ever  will  see." 


CHAPTER  VI. 
OF  THE  INFERIOR  EXTREMITIES. 

THE  inferior  extremities  are  divided  for  each,  into  the  thigh,  the  leg, 
and  the  foot.  The  bones  are  the  os  femoris,  the  tibia,  fibula,  patella, 
and  a  large  number  which  enter  into  the  composition  of  the  foot,  con- 
stituting the  tarsus,  the  metatarsus,  and  the  phalanges. 

SECT.  I. — OF  THE  THIGH  BONE  (Os  Femoris,  Femur). 

This  is  the  only  bone  in  the  thigh,  and  extends  from  the  trunk  to 
the  leg.  It  is  considerably  the  longest  and  largest  bone  in  the  skele- 
ton, and  presents  a  conformation  entirely  peculiar.  For  the  purposes 
of  description,  it  is  divided  into  the  two  extremities  and  the  body. 

The  superior  or  iliac  extremity  presents  three  well-marked  eminences, 
the  head,  the  great  and  the  little  trochanter.  The  head  is  the  articu- 
lar surface  above,  and  forms  rather  more  than  one-half  of  a  perfect 
sphere.  Its  smoothness  indicates  the  existence  of  a  cartilaginous  crust 
on  it  during  life,  and  is  only  interrupted  by  a  small  pit  a  little  below 
its  centre,  which  gives  attachment  to  the  round  ligament  of  the  hip 
joint.  Its  articular  surface  is  more  extensive  above  than  below,  as  that 
part  is  chiefly  employed  in  sustaining  the  trunk,  and  comes  in  contact 
with  a  corresponding  surface  of  the  os  innominatum.  The  head  is  sup- 
ported on  a  branch  of  the  os  femoris  called  the  neck,  which,  projecting 
from  the  internal  face  of  the  bone,  between  the  trochanters,  is  directed 
inwards  and  upwards  at  an  angle  of  about  thirty-five  degrees,  but  vary- 


224  SKELETON. 

ing  in  different  subjects.  The  neck  is  two  inches  in  length,  oval,  or 
resembling  a  flattened  cone,  the  great  diameter  of  which  is  vertical, 
and  arises  by  an  extensive  base  along  the  upper  end  of  the  os  femoris. 
It  has  a  great  multitude  of  foramina  dispersed  over  it,  which  penetrate 
to  its  interior,  and  give  passage  to  blood-vessels;  the  largest  of  them, 
are  on  its  posterior  surface.  Some  of  these  foramina  are  also  occupied 
by  fibres.  A  superficial  horizontal  fossa  may  be  seen  crossing  the  pos- 
terior face  of  the  base  of  the  neck;  it  is  formed  by  the  tendon  of  the 
obturator  externus. 

Fig.  63. 


An  anterior  view  of  the  Femur  of  the  right  side. — 1.  Depression  for  the  round  ligament.  2.  The 
head.  3.  The  neck.  4.  Trochanter  major.  5.  Trochanter  minor.  6.  Surface  for  the  capsular  liga- 
ment. 7.  Shaft  of  the  bone.  8.  The  external  condyle.  9.  The  internal  condyle.  10.  Trochlea  for  the 
patella. 

The  great  trochanter  is  situated  at  the  superior  part  of  the  base  of 
the  neck,  and  though  presenting  a  well-marked,  elevated  summit,  rising 
straight  upwards,  does  not  reach  the  altitude  of  the  head,  but  falls 
short  of  it  half  an  inch.  The  trochanter  major  rests  upon  a  broad 
base,  has  its  surface  much  diversified,  is  somewhat  prominent  in  front 
and  externally;  but  presents  on  the  side  which  is  next  to  the  head  of 
the  bone  a  deep  round  concavity  (fossa  trochanterica],  which  is  occupied 
by  the  insertion  of  the  small  rotatory  muscles  on  the  back  of  the 
pelvis.  On  its  summit  is  a  small  smooth  spot,  made  by  the  insertion 
of  the  pyriformis  muscle ;  below  this,  but  externally,  is  a  broad  surface, 
slightly  convex,  into  which  the  gluteus  medius  is  inserted;  below  this, 
again,  is  a  second  prominent  and  rounded  surface,  over  which  a  part 
of  the  tendon  of  the  gluteus  magnus  plays.  On  the  front  of  the  tro- 


THIGH  BONE.  225 

chanter,  and  just  in  advance  of  the  insertion  of  the  gluteus  medius,  is 
an  oblong  surface,  proceeding  obliquely  downwards  and  outwards,  into 
which  is  inserted  the  gluteus  minimus. 

The  trochanter  minor  is  much  smaller  than  the  other,  and  is  a  coni- 
cal process,  placed  on  the  internal  posterior  face  of  the  bone,  at  the 
lower  end  of  the  root  of  the  neck.  It  receives  the  common  tendon  of 
the  iliacus  internus  and  psoas  magnus  muscles.  A  broad  elevated  ridge 
joins  the  two  trochanters  on  the  posterior  face  of  the  bone,  and  into 
its  middle  half  is  inserted  the  quadratus  femoris  muscle.  A  much 
smaller  ridge,  and  by  no  means  so  elevated,  runs  in  front,  from  the 
one  process  to  the  other,  and  indicates  the  line  of  attachment  of  the 
capsular  ligament  of  the  hip  joint. 

The  inferior  extremity  of  the  os  femoris  is  much  more  voluminous 
than  the  superior,  and  is  divided  into  two  parts,  called  the  internal  and 
the  external  condyle.  These  condyles  are  of  very  nearly  the  same 
size,  but,  being  separated  by  a  notch  behind,  they  are  placed  somewhat 
obliquely  in  regard  to  each  other;  and  the  internal,  from  being  the 
most  oblique,  and  consequently  the  most  protuberant,  also  seems  to  be 
the  larger.  If  the  os  femoris  be  placed  exactly  vertical,  the  internal 
condyle  has  the  appearance  of  being  the  longest ;  but,  if  placed  in  its 
natural  obliquity,  the  lower  face  of  the  condyles  is  on  the  same  plane. 
In  front,  the  condyles  unite  to  form  an  articular  trochlea,  on  which 
the  patella  plays ;  this  trochlea  is  unequally  divided  by  a  vertical  de- 
pression, so  as  to  have  its  more  extensive  surface  external.  This  latter 
surface  is  the  anterior  part  of  the  external  condyle,  and  is  much  more 
elevated  than  the  internal  part  of  the  trochlea,  which  belongs  to  the 
internal  condyle.  Posteriorly,  the  internal  condyle  projects  more  than 
the  external,  and  both  have  the  articular  surfaces,  there,  so  much  elon- 
gated backwards  and  upwards,  as  to  admit  of  a  very  great  flexion  of 
the  leg.  The  upper  posterior  end  of  each  condyle  is  occupied  by  the 
origin  of  the  respective  head  of  the  gastrocnemius  muscle. 

Each  condyle  presents  an  internal  and  an  external  face.  The  inter- 
nal condyle  has  on  its  internal  face  a  tuberosity,  from  which  proceeds 
the  internal  lateral  ligament  of  the  knee;  on  its  external  face  it  forms 
one-half  of  the  notch  which  separates  it  from  the  other  condyle,  and 
at  its  anterior  part  in  the  notch  may  be  observed  a  small  depression, 
from  which  proceeds  the  posterior  or  internal  crucial  ligament.  The 
external  condyle,  also,  has  on  its  external  face  a  tuberosity,  from  which 
proceeds  the  external  lateral  ligament  of  the  knee,  and  just  below  it  a 
depression  for  the  origin  of  the  popliteus  muscle.  Its  internal  face 
forms  the  other  half  of  the  notch  just  mentioned,  and  on  the  posterior 
part  of  this  face  is  a  small  depression  for  the  attachment  of  the  ante- 
rior or  external  crucial  ligament.  The  inferior  face  of  the  condyles  is 
somewhat  flattened,  the  transverse  diameter  of  that  of  the  external 
being  rather  longer  than  the  other.  The  inferior  extremity  of  the 
os  femoris  is  beset  with  foramina,  large  and  small,  for  the  passage  of 
vessels  and  the  attachment  of  fibres. 

The  body  of  the  os  femoris  begins  with  the  trochanters  and  termi- 

VOL.  I. — 15 

I 


226  SKELETON. 

nates  in  the  condyles.  It  is  slightly  bent,  so  as  to  present  the  con- 
vexity of  the  curve  forwards.  Its  size  is  gradually  diminished  to  the 
middle;  it  then  begins  to  enlarge,  and  continues  to  augment  till  it 
terminates  in  the  large  inferior  extremity.  The  body  is  very  nearly 
round,  and  departs  from  that  figure  only  on  its  posterior  face,  where 
an  elevated  rough  ridge  is  found  occupying  the  superior  two-thirds  of 
the  bone,  and  called  the  linea  aspera.  The  linea  aspera  begins  broad, 


A  posterior  view  of  the  Femur  of  the  right  side. — I.  Depression  for  the  round  ligament.  2.  The 
head.  3.  Depression  for  some  of  the  rotatory  muscles.  4.  Trochanter  major.  5.  Trochanter  minor. 
6.  Roughness  for  the  gluteus  magnus  tendon.  7,  7.  The  linea  aspera.  8.  Flat  surface  above  the 
condyles.  9.  The  external  condyle.  10.  Depression  for  the  anterior  crucial  ligament.  11.  De- 
pression for  the  posterior  crucial  ligament.  12.  Point  of  origin  of  the  internal  lateral  ligament. 

rough,  and  flat,  on  a  level  with  the  trochanter  minor;  it  narrows  as  it 
descends,  and  becomes,  at  the  same  time,  more  elevated.  In  the  whole 
course  of  the  linea  aspera,  an  internal  and  an  external  margin  are  very 
obvious.  Its  lower  extremity  bifurcates,  about  four  or  five  inches  above 
the  condyles,  into  two  superficial,  slightly-marked  ridges,  one  on  each 
side,  which  may  be  traced  into  the  posterior  extremity  of  its  corre- 
sponding condyle.  Between  these  ridges  the  surface  of  the  bone  is 
flattened.  The  superior  half  of  the  external  margin  of  the  linea  aspera 
is  marked  by  the  insertion  of  the  gluteus  magnus,  and  the  remainder  of 
the  same  margin,  by  the  origin  of  the  biceps  flexor  cruris.  This  margin 
also  gives  origin  to  the  vastus  externus.  The  internal  margin  of  the 
linea  aspera  and  its  continuous  ridge  are  mostly  occupied  by  the  inser- 
tion of  the  triceps  adductor,  and  by  the  origin  of  the  vastus  internus. 
In  the  linea  aspera,  in  the  upper  part  of  the  middle  third  of  the 
bone,  is  the  canal  for  the  nutritious  artery,  which  slants  upwards: 


THE  LEG. 


227 


occasionally  one  or  more  canals  besides  are  found  in  it  for  the  same 
purpose. 

The  texture  of  the  os  femoris  is  compact  in  its  body.  Its  extremities 
are  cellular,  with  the  exception  of  a  thin  lamina  forming  their  peri- 
phery ;  the  cylindrical  cavity  in  its  middle,  like  that  in  all  the  other 
long  bones,  is  reticulated.  The  ossa  femorum  approach  each  other 
very  closely  at  their  inferior  extremities,  but  are  widely  separated  at 
their  superior  in  consequence  of  the  length  of  their  necks,  and  of  the 
distance  of  the  acetabula  from  one  another. 


SECT.  II.— OF  THE  LEO. 

Two  bones  form  the  leg,  the  tibia  and  the  fibula,  to  which  may  be 
added  the  patella,  from  its  attachment  to  the  tibia. 

Of  the  Tibia  (Tibia). 

The  tibia  is  placed  at  the  internal  side  of  the  leg,  and  extends  from 
the  thigh  to  the  foot.  After  the  os  femoris,  it  is  the  longest  and  the 
largest  bone  in  the  skeleton.  It  is  divided  into  the  body  and  the  two 
extremities. 

The  superior  extremity  of  the  tibia  is  oval  transversely,  and  pre- 
sents an  extent  of  surface  suited  to  the  articular  face  of  the  two  con- 
Fig.  65. 


An  anterior  view  of  the  Tibia  of  the  right  side.— 1.  'Spinous  process  and  pits  for  the  attachment  of 
the  crucial  ligaments.  2,4.  Surface  for  the  condyles  of  the  femur.  3.  Projection  for  the  head  of 
the  fibula.  5.  The  tubercle.  6,  6.  The  spine  and  shaft  of  the  bone.  7.  Internal  malleolus.  8.  Pro- 
cess for  the  internal  lateral  ligament  of  the  ankle.  9.  Tarsal  surface.  10s  Face  for  the  lower  end 
of  the  fibula. 


228  SKELETON. 

dyles  of  the  os  femoris,  to  which  it  is  joined.  It  has  here  two  super- 
ficial cavities  for  receiving  the  ends  of  the  condyleb;  one  of  them  is 
internal  and  the  other  external.  The  internal  is  the  deeper  and  more 
extensive  of  the  two,  and,  being  oval,  has  its  long  diameter  in  an 
antero-posterior  direction.  The  external,  besides  being  smaller  and 
more  superficial,  is  more  circular;  and,  from  the  want  of  elevation  in 
its  margins,  scarcely  presents  at  all  the  appearance  of  a  cavity.  These 
two  cavities,  which  approach  to  within  half  an  inch  of  each  other,  are 
kept  entirely  separated  by  an  elevated  triangular  ridge,  with  a  broad 
base,  called  the  spinous  process  of  the  tibia.  The  summit  of  the  ridge 
presents  two  tubercles,  one  at  each  end,  separated  by  a  pit  which  serves 
to  attach  the  posterior  end  of  the  external  semilunar  cartilage.  The 
ridge  is  placed  nearer  the  posterior  than  the  anterior  margin  of  the 
tibia.  Its  base,  in  front,  is  depressed  for  the  attachment  of  the  ante- 
rior crucial  ligament,  and  just  before  this  is  a  rough,  triangular  space, 
extending  to  the  anterior  margin  of  the  bone  and  covered  by  fat  in  the 
recent  subject.  Between  the  ridge  and  the  posterior  margin  of  the 
bone,  is  a  deep  depression  for  the  attachment  of  the  posterior  crucial 
ligament. 

The  circumference  of  the  superior  part  of  the  tibia,  just  below  its 
articular  surface,  is  flat  before,  somewhat  fiat  and  concave  behind,  and 
bulging  at  the  sides.  The  flatness,  in  front,  is  triangular,  having  its 
base  upwards  and  the  apex  downwards;  the  latter  terminates  in  a  well- 
marked,  broad,  rough  rising,  which  is  the  tubercle  of  the  tibia,  and 
serves  for  the  insertion  of  the  tendon  of  the  patella.  The  concavity 
behind  is  made  by  the  popliteus  muscle,  and  slopes  from  above  obliquely 
inwards  and  downwards.  The  projection  is  large  on  the  internal  side 
of  the  upper  extremity  of  the  tibia,  and  at  its  internal  posterior  part 
has  a  depression  made  by  the  insertion  of  the  semi-membranosus  ten- 
don. The  external  projection  is  thicker  in  front  than  behind;  at  the 
latter  point  it  has  a  small  articular  face,  looking  downwards,  for  the 
head  of  the  fibula. 

The  inferior  extremity  of  the  tibia  is  much  smaller  than  the  superior. 
It  is  terminated  by  a  transverse  quadrilateral  cylindrical  cavity,  by 
which  it  articulates  with  the  astragalus.  This  concavity  is  narrower 
and  deeper  internally,  than  externally,  and  is  traversed  from  before 
backwards  by  a  low  broad  elevation.  It  is  bounded  internally  by  the 
internal  ankle  (malleolus  internus),  a  large  process  of  half  an  inch  in 
length,  the  external  side  of  which  is  a  continuous  surface  with  the 
cylindrical  concavity,  and  forms  part  of  the  joint.  The  other  side  of 
the  malleolus  is  superficial,  being  just  beneath  the  skin.  A  shallow 
groove  exists  in  its  posterior  part,  which  transmits  the  tendon  of  the 
tibialis  posticus  and  of  the  flexor  longus  digitorum  pedis.  Inferiorly, 
the  malleolus  is  notched,  or  presents  a  depression,  for  the  origin  of  the 
internal  lateral  ligament,  and  just  before  the  depression  it  is  elongated 
into  a  point.  The  lower  end  of  the  tibia  presents,  before  and  behind, 
a  slight  swell,  running  transversely  just  above  the  articular  surface. 
The  posterior  swell  is  occasionally  slightly  marked  by  the  tendon  of 
the  flexor  longus  pollicis  pedis. 


THE  LEG.  229 

Externally,  the  circumference  of  the  lower  end  of  the  tibia  presents, 
longitudinally,  a  rough  concavity  which  is  in  contact  with  the  lower 
end  of  the  fibula.  This  concavity  terminates  insensibly  above,  but  is 
deep  below,  where  it  is  bounded  before  and  behind  by  an  elevated  point 
of  bone,  of  which  the  posterior  is  the  higher.  The  concavity  is  placed 
nearly  in  the  vertical  line  of  the  little  articular  face  for  the  fibula,  on 
the  head  of  the  tibia  ;  and  at  its  lower  margin,  there  is  frequently  a  small 
lunated  surface,  which  is  continuous  with  the  articular  surface  for  the 
astragalus,  and  is  consequently  a  part  of  the  cavity  of  the  ankle 
joint.  Just  above  this  lunated  surface  the  bone  is  rough  for  the  origin 
of  short  ligamentous  fibres,  which  unite  it  to  the  fibula. 

The  body  of  the  tibia  commences  just  below  the  enlarged  upper  ex- 
tremity, and  terminates  near  the  ankle.  In  the  front  view  of  it,  it 
diminishes  continually  in  descending,  in  its  superior  two-thirds :  after- 
wards it  enlarges  gradually  to  the  lower  extremity ;  in  the  lateral  view 
it  diminishes  downwards  almost  to  the  lower  extremity.  It  is  slightly 
bent  forwards,  and  is  generally  prismatic,  more  particularly  above ; 
one  of  its  faces  is  internal,  another  external,  and  the  third  posterior. 
The  internal  face  is  rounded,  and,  with  the  exceptions  of  its  upper 
part,  where  the  flexor  tendons  are  inserted,  it  is  covered  by  the  skin 
only.  Its  external  face  is  flat,  excepting  below,  where  it  is  rounded 
and  is  covered  by  the  muscles  on  the  front  of  the  leg.  The  posterior 
face  is  slightly  rounded,  except  at  its  upper  part  where  it  is  crossed  by 
a  line  running  obliquely  from  the  articular  surface  for  the  fibula,  down- 
wards and  inwards:  above  which  line,  is  the  superficial  triangular 
depression  for  the  popliteus  muscle. 

The  three  sides  of  the  tibia  are  marked  off  from  each  other  by 
ridges  of  bone.  The  anterior  ridge,  called  the  spine  or  crest  (crista), 
begins  at  the  external  margin  of  the  tubercle  for  the  insertion  of  the 
tendon  of  the  patella,  and  may  be  traced  very  distinctly,  in  the  form  of 
an  S  very  slightly  curved,  almost  to  the  malleolus  internus:  it  is  more 
elevated  in  its  middle.  The  external  ridge  is  a  straight  line  running 
from  one  extremity  of  the  bone  to  the  other ;  to  it  is  attached  one  edge 
of  the  interosseous  ligament.  The  internal  ridge  is  rounded,  but  also 
runs  the  whole  length  of  the  body  of  the  bone,  being  more  distinct  be- 
low. The  internal  lateral  ligament  of  the  knee  and  the  soleus  muscle 
are  attached  to  it,  above;  and  the  flexor  longus  digitorum  pedis,  below. 

Foramina  large  and  small,  for  blood-vessels  and  fibres,  are  found  on 
the  circumference  of  both  extremities  of  the  tibia.  On  its  posterior 
face,  about  one-fourth  of  its  length  from  the  head,  is  a  large  canal 
sloping  downwards,  through  which  passes  the  nutritious  artery.  Its 
structure,  like  that  of  the  other  long  bones, is  cellular  at  its  extremities; 
but  compact  in  the  body,  where  it  presents  a  cavity  occupied  by  can- 
cellated matter.  It  will  now  be  understood  how  it  articulates  with  the 
fibula,  externally  at  both  ends  ;  with  the  os  femoris  above ;  and  with  the 
astragalus  below. 


230  SKELETON. 

Of  the  Fibula  (Perone). 

The  fibula  is  placed  at  the  external  side  of  the  tibia,  and  extends 
from  the  head  of  the  latter  to  the  foot:  it  is  much  smaller,  and  not 
quite  so  long  as  the  tibia,  and  is  so  articulated  with  it  as  to  be  on  a 
line  with  its  posterior  face.  It  is  to  be  studied  in  its  two  extremities 
and  in  its  body. 

Fig.  66. 


An  anterior  view  of  the  Fibula  of  the  right  side.  1,2.  Articular  face  for  the  tibia.  3.  Point  of 
insertion  of  the  external  lateral  ligament.  4.  Shaft  of  the  bone.  5,5.  External  face,  for  the  pero- 
neus  primus  and  secundus  muscles.  6.  Interosseous  ridge.  7.  Face  for  the  lower  end  of  the  tibia. 
8.  Malleolus  externus. 

The  upper  extremity  of  the  fibula  is  considerably  enlarged  and  irregu- 
lar. It  presents,  above,  a  small  articular  face  directed  upwards  and 
very  slightly  concave,  by  which  it  joins  the  corresponding  face  of  the 
tibia.  This  surface  is  bounded  behind  by  a  sort  of  styloid  process, 
into  which  is  inserted  the  tendon  of  the  biceps  flexor  cruris.  The  cir- 
cumference of  the  bone,  in  advance  of  this,  furnishes  attachment  to  the 
external  lateral  ligament  of  the  knee. 

The  inferior  extremity  of  the  fibula  is  also  enlarged,  being  flattened 
on  its  tibial  side,  but  more  rounded  externally.  This  part  of  the  fibula 
is  called  the  external  ankle  (malleolus  externus}.  It  descends  lower 
than  the  internal  ankle,  and  is  also  more  prominent  and  large.  Its 
tibial  side  presents,  below,  a  small  triangular,  slightly  convex  articulating 
surface,  which  is  against  the  side  of  the  astragalus ;  behind,  and  some- 
what below  it,  is  a  small  rough  excavation,  which,  with  the  adjoining 
inferior  margin  of  the  bone,  gives  origin  to  the  three  fasciculi  of  the 
external  lateral  ligament  of  the  ankle.  Above  the  articular  surface, 


THE  LEG.  231 

the  bone  is  rough  and  slightly  rounded  where  it  is  received  into  the 
side  of  the  tibia,  and  sends  off  many  short  ligamentous  fibres  to  it. 
The  anterior  margin  of  this  extremity  of  the  fibula  is  thin  and  pro- 
jecting ;  the  posterior  surface  is  flat  and  broad,  and  is  slightly  scooped 
out  into  a  longitudinal  groove,  which  transmits  the  tendons  of  the  two 
peronei  muscles.  The  pointed  termination  below,  of  the  malleolus 
externus,  is  sometimes  called  the  coronoid  process. 

The  body  of  the  fibula  extends  between  its  extremities.  It  is  irregu- 
larly triangular,  somewhat  smaller  above  than  below,  thick  posteriorly, 
thin  anteriorly,  and  slightly  convex  in  its  length  behind. 

There  are  three  faces  to  the  fibula,  one  is  external,  another  internal, 
and  the  third  posterior.  The  first  is  semi-spiral,  and  turned  forwards 
above  ;  its  superior  third  gives  origin  to  the  peroneus  primus  muscle, 
and  the  middle  third  to  the  peroneus  secundus  ;  its  lower  third  exhibits 
the  semi-spiral  arrangement  which  may  be  traced  into  the  groove  on 
the  posterior  part  of  the  malleolus  externus,  and  thereby  indicates  the 
course  of  the  tendons  of  these  peronei  muscles.  The  internal  face  is 
directed  towards  the  tibia ;  it  is  divided  by  a  low  longitudinal  ridge 
into  two  parts,  of  which  the  anterior  is  the  narrower.  The  ridge  itself, 
well  marked  in  the  middle  two-fourths  of  the  bone,  is  indistinct  above 
and  below,  and  furnishes  attachment  to  the  interosseous  ligament. 
The  space  in  front  gives  origin  to  the  extensor  proprius  pollicis,  and 
the  extensor  communis  digitorum  :  and  the  space  behind  gives  origin  to 
the  tibialis  posticus.  The  posterior  face  is  also  somewhat  semi-spiral, 
its  superior  end  being  outwards,  and  the  inferior  end  inwards.  The 
superior  third  gives  origin  to  the  soleus  muscle,  and  the  remainder  to 
the  flexor  longus  pollicis  pedis. 

The  angles  of  the  fibula,  which  are  formed  by  the  junction  of  the 
three  surfaces  described,  differ  somewhat  among  themselves.  The  an- 
terior angle  is  frequently  very  sharp  and  elevated  in  its  middle  half, 
and  below  it  bifurcates  into  two  ridges,  including  between  them  a  tri- 
angular space  above  the  external  ankle,  and  which  is  covered  by  the 
integuments  only.  The  posterior  angle  is  well  marked,  and  winds  so 
as  to  be  external  above,  and  posterior  near  the  foot.  The  internal 
angle,  formed  by  the  union  of  the  internal  and  the  posterior  surfaces, 
is  only  very  well  marked  in  its  middle  half.  The  projection  of  this  angle 
gives  to  the  bone  the  appearance  of  inclining  inwards  towards  the  tibia, 
besides  which  it  has  actually  a  little  bend  in  that  direction. 

Near  the  middle  of  the  posterior  face  of  the  fibula,  a  canal,  sloping 
downwards,  conducts  the  nutritious  artery.  The  circumference  of  the 
extremities,  like  that  of  the  other  long  bones,  presents  a  multitude  of 
foramina  for  vessels  and  the  filaments  of  fibres  to  pass.  It  is  composed 
in  its  extremities  of  cellular  or  spongy  structure,  and  in  its  body  of 
compact  matter,  enclosing  a  cavity  occupied  by  cancellated  structure. 


232  SKELETON. 

Of  the  Patella  (Rotule). 

The  patella  is  a  small  bone,  intermediate  to  the  thigh  and  to  the  leg, 
and  placed  on  the  fore  part  of  the  knee  joint ;  it  is  smaller  in  propor- 
tion in  females  than  in  males. 

Its  anterior  face  being  uniformly  convex,  is  rough  and  studded  with 
a  considerable  number  of  foramina  for  the  passage  of  vessels,  and  for 
the  attachment  of  fibres.  The  course  of  the  longitudinal  ridges  corn- 
Fig.  67. 


An  anterior  view  of  the  Patella. — 1,  2.  Surface  for  the  quadriceps  femoris  tendon.    3.  Lower  extre- 
mity and  point  of  origin  of  the  ligamentum  patellae. 

posing  the  front  of  the  bone  is  well  marked.  The  posterior  face  of  the 
patella  is  an  extensive  articular  surface,  divided  unequally  by  a  broad 
longitudinal  elevation,  which  runs  from  the  superior  to  the  inferior 
margin  of  the  bone.  The  part  of  this  surface  external  to  the  ridge  is 
the  largest  and  the  most  concave,  and  is  applied  to  the  trochlea,  in 
front  of  the  external  condyle  of  the  os  femoris;  while  the  smaller  sur- 
face is  on  the  internal  side  of  the  ridge,  and  is  applied  to  the  trochlea 
of  the  internal  condyle. 

The  circumference  of  the  patella  is  nearly  oval,  the  long  diameter 
being  transverse.  Its  thickness  is  much  augmented  above,  where  it 
presents  a  rough  and  somewhat  unequal  flatness  for  the  insertion  of  the 
tendon  of  the  rectus  femoris.  Below,  the  bone  is  thinner,  and  elon- 
gated into  a  conical  point,  from  which  proceeds  the  tendon  of  the 
patella  to  be  inserted  into  the  tibia.  Laterally,  the  margins  are  thin- 
ner still. 

The  texture  of  the  patella  is  cellular,  covered  by  a  lamina  of  con- 
densed bony  matter.  It  is  developed  in  the  tendon  of  the  extensors  of 
the  thigh,  and  with  the  exception  of  its  posterior  face,  remains  in  a 
state  almost  entirely  cartilaginous,  for  a  year  or  two  after  birth.  In 
its  fracture,  union  is  effected  more  frequently  by  the  fibrous  base  alone, 
than  by  perfect  ossification.  To  put  it  into  its  proper  position,  turn  the 
point  downwards,  and  apply  the  greater  surface  behind,  to  the  trochlea 
of  the  external  condyle.  The  patella  is  said  to  be  to  the  tibia  what  the 
olecranon  is  to  the  ulna ;  and  is,  therefore,  a  sort  of  appendage  to  it, 
united  by  ligament  instead  of  being  continuous  with  it,  as  is  the  case 
with  the  olecranon. 


THE  FOOT.  233 


SECT.  III. — OF  THE  FOOT. 

The  foot  forms  the  third  portion  of  the  inferior  extremity,  and  is 
placed  at  a  right  angle  to  the  bones  of  the  leg.  The  size  of  its  bones 
varies  much  in  different  individuals,  depending  largely  upon  their 
modes  of  life  and  dress  ;  it  also  varies  considerably  in  the  two  sexes, 
being,  for  the  most  part,  smaller  in  proportion  in  the  female.  The  foot 
is  oblong,  narrower  behind  than  before ;  presents  one  surface  above, 
which  is  its  back,  and  another  below,  which  is  the  sole ;  a  posterior  ex- 
tremity called  the  heel,  and  an  anterior  extremity  called  the  point.  Its 
internal  margin  is  much  thicker,  longer,  and  more  concave  than  the 
external  margin. 

The  foot  is  divided  into  Tarsus,  Metatarsus,  and  Toes,  or  Phalanges. 

i 

Fig.  68. 


A  view  of  the  upper  surface  of  the  Left  Foot. — 1.  The  astragalus  on  its  upper  face.  2.  Its  ante- 
rior face,  articulating  with  the  naviculare.  3.  The  os  calcis.  4.  Naviculare,  or  scaphoides.  5.  The 
internal  cuneiform.  6.  The  middle  cuneiform.  7.  The  external  cuneiform.  8.  ''he  cuboid  bone. 
9.  Metatarsal  bones.  10.  First  phalanx  of  the  big  toe.  11.  Second  phalanx  of  the  big  toe.  1212, 
13  13,  14  14.  The  first,  second  and  third  phalanges  of  the  other  toes. 


Of  the   Tarsus  (Tarse}. 

The  tarsus  forms  the  posterior  half  of  the  foot,  and  is  composed  of 
seven  distinct  bones,  which  are  arranged  on  a  plan,  and  present  features 
having  scarcely  a  single  point  of  resemblance  with  the  carpus.  These 
bones  are,  the  Os  Calcis,  the  Astragalus,  the  Naviculare  or  Scaphoides, 
the  Cuboides,  the  Cuneiforme  Externum,  Cuneiforme  Medium,  and 
Cuneiforme  Internum. 


234  SKELETON. 

Of  the  Os  Oalcis  (Calcaneum). 

The  os  calcis,  or  heel  bone,  forms,  almost  exclusively,  the  posterior 
half  of  the  tarsus,  and  may  be  readily  distinguished  by  its  greater 
magnitude.  Its  shape  is  very  irregular.  Its  greatest  diameter  is  in 
the  length  of  the  foot ;  it  is  also  thicker  vertically  than  transversely. 

The  superior  face  is  deeply  scoopecfr  out  at  its  fore  part,  and  is 
formed  there  into  two  articular  surfaces,  for  joining  with  the  astragalus  : 
these  faces  are  separated  by  a  rough  fossa,  which  runs  from  within  ob- 
liquely forwards  and  outwards,  and  accommodates  a  ligament.  The  ante- 
rior external  part  of  this  fossa  is  deep,  broad  and  triangular;  the  posterior 
part  is  narrow,  is  occupied  by  a  ligament,  and  allows  the  two  articular 
surfaces  to  come  nearer.  Just  behind  the  fossa  is  the  first  articulating 
surface,  lying  parallel  with  it;  being  oblong,  convex,  semi-cylindrical, 
and  looking  obliquely  upwards  and  forwards.  Before  the  fossa  is  the 
second  surface:  it  is  oblong,  much  smaller  than  the  first,  and  is  very 
frequently  divided  into  two  by  a  transverse  notch,  and  is  concave. 
The  part  of  the  bone  upon  which  this  face  is  wrought,  is  called,  by 
the  French,  the  little  apophysis.  I  have  frequently  remarked,  that 
the  face  posterior  to  the  first-mentioned  fossa,  is  smaller  and  more  ver- 
tical in  the  African  than  in  the  European ;  the  os  calcis,  behind  it,  is 
also  smaller  and  longer.  The  upper  posterior  face  of  the  bone  is 
somewhat  concave. 

The  under  surface  of  the  os  calcis  is  slightly  concave,  longitudinally. 
It  is  bounded,  behind,  by  two  tuberosities,  of  which  the  internal  is 
larger  than  the  external ;  they  both  give  origin  to  muscles  of  the  sole 
of  the  foot  and  to  the  aponeurosis  plantaris.  There  is  also  a  tuberosity 
bounding  the  same  surface  in  front,  from  which  arise  the  ligaments 
that  connect  this  bone  with  the  adjoining  ones. 

The  anterior  extremity  of  the  os  calcis  forms  the  greater  apophysi^ 
and  is  terminated  in  front  by  a  triangular  semi-spiral  concave  surface, 
by  which  it  articulates  with  the  os  cuboides.  The  posterior  extremity 
is  convex  and  rough :  constitutes  the  heel,  and  near  its  middle  receives 
the  tendo-Achillis  ;  above  this  the  surface  is  sloping  and  more  smooth, 
in  order  to  accommodate  this  tendon  in  the  flexions  of  the  foot. 

The  external  surface  of  the  os  calcis  is  flat,  with  the  exception  of  a 
gentle  rising  in  its  middle  ;  it  is  marked,  occasionally,  by  a  superficial 
groove,  indicating  the  course  of  the  tendons  of  the  peronei  muscles. 
The  internal  surface  is  very  concave,  and  obtains  the  name  of  sinuosity  ; 
along  it  pass  the  tendons  of  several  muscles  from  the  back  of  the  leg, 
of  which  that  of  the  flexor  longus  pollicis  pedis  makes  a  conspicuous 
groove  on  the  under  surface  of  the  little  apophysis,  at  its  base.  The 
point  of  the  apophysis  makes  a  trochlea  for  the  tendon  of  the  tibialis 
posticus. 


THE  FOOT.  235 

Of  the  Astragalus  (L'Astragale). 

This  is  the  next  in  size  to  the  os  calcis,  and  is  placed  on  the  superior 
part  of  the  latter,  between  it  and  the  bones  of  the  leg. 

The  astragalus  presents,  above,  a  projecting  semi-cylindrical  surface, 
by  which  it  is  put  in  contact  with  the  tibia.  This  surface  is  narrower, 
and  continued  farther  behind  than  it  is  before  ;  is  slightly  depressed, 
longitudinally,  near  its  middle,  and,  consequently,  presents  an  elevated 
margin  on  either  side,  of  which  the  external  is  the  broadest  and  highest. 
This  articular  face  continues  on  each  side  of  the  bone,  and  is  more 
extensive  externally,  where  it  comes  in  contact  with  the  fibula  or 
malleolus  externus,  than  internally,  where  it  touches  the  malleolus 
internus. 

The  inferior  face  of  the  astragalus  is  traversed  by  an  oblique  rough 
fossa,  going  from  within  outwards  and  forwards,  and  corresponding  in 
size  and  appropriation  with  that  on  the  upper  face  of  the  os  calcis. 
Behind  the  fossa,  and  parallel  with  it,  is  a  deep  oblique  semi-cylin- 
drical cavity,  suited  to  the  adjoining  face  of  the  os  calcis ;  and  before 
the  fossa  is  a  narrow  oblong  projection,  suited  to  the  corresponding 
articular  cavity  of  the  same  bone.  When  this  concavity  is  divided 
into  two  facets,  the  projection  of  the  astragalus  presents  also  two  facets, 
separated  by  a  small  ridge. 

The  anterior  extremity  of  this  bone  is  terminated  by  a  hemispherical 
head,  the  horizontal  diameter  of  which  is  the  longer.  This  head  arti- 
culates with  the  scaphoides,  and  is  continuous  with  the  surface  that 
rests  upon  the  little  apophysis  of  the  os  calcis.  On  the  internal  side 
of  the  head  is  a  small  triangular  surface,  continuous  with  the  others, 
that  rests  upon  the  strong  ligament  going  from  the  os  calcis  to  the 
scaphoides.  Above,  immediately  before  the  surface  for  the  tibia,  is  a 
small  depression,  which,  in  the  flexions  of  the  foot,  receives  the  ante- 
rior margin  of  the  articular  surface  of  that  bone.  The  posterior  ex- 
tremity of  the  astragalus  is  thin,  and  has  a  notch,  or  groove  formed  in 
it  by  the  tendon  of  the  flexor  longus  pollicis  pedis. 

Of  the  Naviculare,  or  Scaphoides  (Scaphoide}. 

It  is  situated  at  the  internal  side  of  the  tarsus,  between  the  astra- 
galus and  the  cuneiform  bones,  and  has  its  longest  diameter  transverse. 
Its  circumference  is  oval,  thicker  above  than  below,  and  its  internal 
side  presents  a  large  tuberosity ;  into  which  is  inserted  the  tendon  of 
the  tibialis  posticus.  Sometimes  the  external  margin  has  a  small  arti- 
cular face,  where  it  comes  in  contact  with  the  cuboides. 

The  scaphoides  presents,,  behind,  a  deep  cavity,  which  receives  the 
head  of  the  astragalus ;  anteriorly,  it  is  somewhat  convex,  but  this  sur- 
face is  divided  by  small  ridges  into  three  triangular  faces,  for  the  three 
cuneiform  bones.  Of  these  faces  the  internal  is  broader  below  than 
above ;  the  others  are  broader  above  than  below. 


236  SKELETON. 

Of  the  Cuboides  (Cuboide). 

It  is  situated  at  the  external  side  of  the  tarsus,  between  the  os  calcis 
and  the  metatarsal  bones.  Its  figure  is  irregular,  but,  perhaps,  suf- 
ficiently indicated  by  its  name.  It  is  narrower  externally  than  in- 
ternally, and  has  the  posterior  extremity  oblique. 

The  superior  face  of  the  cuboides  is  rounded,  but  rough.  The  infe- 
rior face  has  in  its  middle  a  broad  elevated  ridge,  running  almost  trans- 
versely, but  somewhat  forwards.  The  external  extremity  of  this  ridge 
is  marked  by  a  trochlea,  on  which  plays  the  tendon  of  the  peroneus 
longus;  the  tendon  is  then  conducted  along  a  groove  between  the  ridge 
and  the  anterior  margin  of  the  bone. 

The  internal  face  is  flat,  and  has  in  its  middle  a  circular  face,  where 
it  comes  in  contact  with  the  cuneiform  externum.  The  posterior  face 
joins  the  os  calcis,  is  triangular,  and  semi-spiral.  The  anterior  face  is 
oblong,  transverse,  and  is  divided  by  a  slight  vertical  rising  into  two, 
for  articulating  with  the  two  outer  metatarsal  bones. 

Of  the  Cuneiforme  Internum  (Premier  Cuneiforme). 

It  is  placed  at  the  internal  anterior  extremity  of  the  tarsus,  between 
the  scaphoides  and  the  first  metatarsal  bone,  and  may  be  distinguished 
from  the  other  cuneiforms  by  its  greater  size.  Its  thickest  part  is 
below. 

Fig.  69. 


An  anterior  view  of  the  three  Cuneiform  Bones,  and  also  of  the  Cuboid  of  the  right  side. — 1.  The 
cuboid.    2.  The  Cuneiforme  externum.    3.   The  cuneiforme  medium.    4.  The  cuneiforme  internum. 

The  anterior  face  presents  a  long  vertical  rising,  which  joins  the  first 
metatarsal  bone.  The  posterior  face  is  not  so  extensive,  and  is  formed 
into  a  triangular  cavity,  having  the  broadest  part  below,  and  which 
joins  the  internal  facet  of  the  scaphoides.  The  internal  side  is  semi- 
cylindrical  and  rough  ;  it  is  marked,  at  its  inferior  anterior  part,  near 
its  middle,  by  the  tendon  of  the  tibialis  anticus.  The  external  side  is 
somewhat  concave,  and  generally  rough,  and  is  marked  just  below  its 
superior  margin  by  two  articular  facets,  of  which  the  anterior  is  the 
smaller,  and  comes  in  contact  with  the  second  metatarsal  bone ;  the 
posterior,  from  its  concave  obliquity,  gives  a  slope  to  the  upper  margin 
of  the  bone,  and  is  in  contact  with  the  cuneiforme  medium. 


THE  FOOT.  237 

Of  the  Cuneiforme  Medium  (Seconde  Cuneiforme). 

The  middle  or  second  cuneiform  bone  is  placed  upon  the  scaphoides, 
immediately  on  the  outside  of  the  cuneiforme  internum.  It  may  be  dis- 
tinguished by  being  the  smallest  bone  of  the  tarsus.  Its  figure  re- 
sembles sufficiently  well  a  wedge,  the  base  of  which  is  above,  and  the 
edge  below. 

Its  posterior  face  is  slightly  concave  where  it  joins  the  scaphoides ; 
the  anterior  face  is  slightly  convex,  and  articulates  with  the  second 
metatarsal  bone.  The  internal  face  presents,  superiorly,  an  oblong, 
slightly  convex,  oblique  articular  facet,  which  touches  the  cuneiforme 
internum;  what  remains  of  this  side,  being  below,  is  rough,  for  the 
origin  of  ligamentous  fibres.  The  external  face  is  uneven,  and  pre- 
sents, at  its  posterior  part,  a  vertical  articular  face  for  joining  the 
cuneiforme  externum ;  but,  anteriorly,  it  is  rough  for  the  origin  of 
ligamentous  fibres. 

In  the  articulated  foot  the  lower  part  of  this  bone  is  almost  concealed 
between  the  other  two  cuneiforms. 

Of  the  Cuneiforme  Externum  ( Troisieme  Cuneiforme}. 

The  external  or  third  cuneiform  bone  is  placed  upon  the  scaphoides, 
between  the  second  cuneiform  and  the  cuboides.  Of  the  three  cunei- 
form bones,  it  is  the  second  in  size,  and  is  also  appropriately  named 
from  its  shape.  The  base  is  upwards. 

The  posterior  face  furnishes,  on  its  superior  half  to  join  the  sca- 
phoides, a  quadrangular  articular  facet,  sloping  outwardly,  below  which 
the  bone  projects  into  the  sole  of  the  foot.  The  anterior  face  is  flat,  and 
articulates  with  the  third  metatarsal  bone.  The  internal  face  presents, 
above,  two  articular  facets,  of  which  the  one  at  the  posterior  end  is 
larger  than  the  other,  and  joins  the  second  cuneiform ;  the  other,  at 
the  anterior  end,  is  very  small,  and  touches  the  second  metatarsal 
bone.  Below  these  facets  the  bone  is  rough,  and  gives  origin  to  liga- 
mentous matter.  The  external  face,  at  the  middle,  forms  an  angular 
projection,  behind  which  is  a  small  oval  articular  surface  that  joins  the 
cuboides.  The  remainder  of  this  face  is  rough,  for  the  origin  of  liga- 
ments, with  the  exception  of  a  very  small  articular  facet  at  the  anterior 
superior  corner,  which  joins  the  fourth  raetatarsal  bone. 


The  structure  of  the  bones  of  the  Tarsus  is  uniformly  cellular  within, 
the  cells  being  enclosed  by  a  thin  lamina  of  condensed  matter.  The 
astragalus  is  rather  stronger  and  more  compact  than  any  of  the  others. 
I  have  seen  one  instance,  however,  in  which  it  had  been  separated  into 
two  pieces  by  a  transverse  vertical  fracture,  going  from  the  ankle  joint 
to  the  articulation  with  the  os  calcis.  The  observation  was  made  after 
it  had  been  boiled  ;  the  callus  had  completely  united  the  two  fragments, 
and  no  displacement  had  occurred. 


238  SKELETON. 

If  a  vertical  section  of  the  os  calcis  and  of  the  astragalus  be  made, 
the  parietes  of  the  cells  are  found  to  radiate  from  the  upper  articular 
surfaces  like  columns,  so  as  to  prevent  the  bones  from  being  crushed  by 
the  vertical  weight  of  the  body. 

Of  the  Metatarsus  (Metatarse). 

The  metatarsus  succeeds  to  the  tarsus,  and  is  formed  by  five  long 
parallel  bones  like  the  metacarpus.  They  are  called  numerically, 
beginning  on  the  inner  side,  or  that  of  the  great  toe.  There  are  four 
intervals  between  them,  which  are  filled  up  by  the  interosseous  muscles. 
The  posterior  end  is  the  base,  and  the  anterior  the  head.  The  base  is 
large  and  triangular ;  the  head  is  a  hemisphere  compressed  from  side  to 
side.  The  body  is  flattened,  laterally,  by  the  pressure  of  the  interos- 
seous muscles. 

Of  the  First  Metatarsal  Bone. 

Placed  at  the  inner  side  of  the  foot  upon  the  cuneiforme  internum, 
and  forming  the  base  of  the  great  toe,  it  may  be  readily  distinguished 
in  the  separated  bones  by  its  greater  size  and  its  shortness. 

The  posterior  extremity  presents  an  oblong  articular  concavity,  the 
greatest  length  of  which  is  vertical,  for  joining  the  cuneiforme  internum. 
The  internal  semi-circumference  of  this  extremity  is  protuberant,  while 
the  external  is  slightly  concave  or  flat,  it  presenting  below  a  prominent 
tubercle,  into  which  is  inserted  the  tendon  of  the  peroneus  longus,  and 
frequently  there  is  above  a  facet,  where  it  articulates  with  the  base  of 
the  second  metatarsal. 

The  anterior  extremity,  or  the  head,  is  rounded  and  convex,  forming 
an  articular  surface  for  the  first  phalanx  of  the  great  toe.  This  sur- 
face is  continued  far  back  below,  and  presents  there,  for  the  sesamoid 
bones,  a  trochlea  with  a  longitudinal  ridge  in  its  middle.  The  lateral 
surfaces  of  the  head  are  rough  and  concave,  for  the  origin  of  the  lateral 
ligaments. 

The  body  is  much  smaller  than  the  extremities,  and  is  prismatic. 
Its  internal  side  is  rounded,  the  external  side  flattened,  and  the  inferior 
side  concave,  longitudinally,  for  lodging  the  muscles  of  the  great  toe. 

Of  the  Second  Metatarsal  Bone. 

This  is  the  longest  of  any,  and  may  be  distinguished  from  the  others 
principally  by  that  circumstance. 

The  posterior  extremity  is  prismatic,  the  base  being  above.  It  pre- 
sents a  surface  very  slightly  concave,  almost  flat,  which  rests  upon  the 
cuneiforme  medium.  The  sides  of  this  extremity  being  flattened  late- 
rally, it  is  locked  in  between  the  internal  and  external  cuneiforms ;  on 
its  internal  side,  above,  is  an  articular  facet,  where  it  comes  in  contact 
with  the  cuneiforme  internum  and  first  metatarsal ;  and,  externally, 


THE  FOOT.  239 

above,  it  has  two  articular  facets.  The  posterior  one  of  the  latter 
touches  the  cuneiforme  externum,  and  the  anterior,  which  is  smaller, 
comes  in  contact  with  the  third  inetatarsal  bone.  These  two  facets  run 
together  by  an  angular  rising. 

The  anterior  extremity  is  prominent  and  rounded ;  its  vertical  dia- 
meter is  more  considerable  than  its  transverse,  and  the  articular  face 
which  it  furnishes  to  the  second  toe  is  continued  considerably  below, 
in  order  to  assist  the  flexion  of  the  first  phalanx.  Its  circumference 
is  rough,  and  flattened  laterally  for  the  origin  of  the  ligaments. 

The  body  is  smaller  than  either  of  the  extremities,  and  decreases 
gradually  from  behind  forwards.  It  is  flattened  on  each  side,  and 
elevated  longitudinally  above  and  below,  into  a  ridge.  There  is  a 
curvature  in  its  length,  which  makes  it  bowed  above,  and  concave 
below,  for  the  lodging  of  muscles. 

Of  the  Third  Metatarsal  Bone. 

This  is  rather  shorter  than  the  second,  but  has  very  much  the  same 
shape. 

Its  posterior  extremity,  or  base,  is  wedge-shape,  having  the  base 
above,  and  the  edge  below,  which  is  not  so  sharp  as  the  preceding.  It 
articulates  with  the  third  cuneiform ;  the  surface  for  the  latter  slopes 
outwardly.  Its  superficies  is  flattened  laterally,  and  presents,  internally, 
at  its  posterior  corner,  a  small  face,  which  articulates  with  the  second 
metatarsal ;  externally,  it  also  presents,  at  its  superior  corner,  an  arti- 
cular facet,  which  joins  the  fourth  metatarsal. 

Its  body  and  anterior  extremity  do  not  present  any  essential  points 
of  difference  from  the  second  metatarsal. 


Of  the  Fourth  Metatarsal  Bone. 

It  is  somewhat  shorter  than  the  third,  and  is  placed  upon  the  internal 
of  the  two  anterior  faces  of  the  cuboides. 

The  posterior  extremity,  or  base,  is  more  an  oblong  than  the  base  of 
the  preceding  bones,  and  has  somewhat  of  a  bent  condition.  It  pre- 
sents an  articular  face  to  the  cuboides,  and  which  is  also  square  or 
nearly  so,  flat,  and  slopes  outwardly.  On  its  sides  it  is  irregular;  in- 
ternally, at  the  superior  margin,  it  has  two  articular  facets,  continuous 
with  each  other,  but  forming  thereby  an  obtuse  angle ;  the  anterior 
joins  the  third  metatarsal ;  and  the  posterior,  which  is  much  the  smaller, 
touches  the  cuneiforme  externum.  Below  these,  the  surface  is  rough. 
The  articulation  with  the  cuneiforme  externum  is  occasionally  deficient. 
I  have  observed  the  latter,  particularly  in  the  negro,  and  it  seems  to 
arise  from  the  unusual  development  of  the  cuboides.  The  external 
surface  of  the  base  has  at  its  superior  corner  an  articular  facet  for  the 


240  SKELETON. 

fifth  metatarsal  bone,  and  below  it  an  oblique  deep  fossa,  before  which 
is  a  tubercle. 

The  anterior  extremity  and  the  body  of  this  bone,  though  smaller 
than  those  of  the  preceding,  do  not  present  any  essential  points  of 
difference. 

Of  the  Fifth  Metatarsal  Bone. 

This  is  shorter  than  any  of  the  others,  excepting  the  first,  and  is 
placed  on  the  front  of  the  cuboides,  externally. 

Its  base  is  remarkable,  and  distinguishes  it  strongly,  by  being  pro- 
jected considerably  beyond  the  external  margin  of  the  cuboides,  and 
forming  there  a  large  tubercle,  into  the  superior  part  of  which  is  in- 
serted the  tendon  of  the  peroneus  tertius,  and  into  the  posterior  part, 
the  tendon  of  the  peroneus  secundus.  The  base,  also,  has  a  triangular 
flat  surface,  sloping  considerably  outwards,  which  articulates  with  the 
cuboides.  On  the  internal  side  is  the  articular  facet,  whereby  it  joins 
the  base  of  the  fourth  metatarsal  bone.  The  base  is  flattened  below, 
rough,  and  somewhat  convex  above. 

The  anterior  extremity  is  more  rounded  than  that  of  the  other  meta- 
tarsal bones,  but  in  other  respects  similar.  The  body  is  prismatic; 
being  flat  below,  flat  internally,  and  slightly  rounded  externally. 

Of  the  Toes. 

The  toes  are  five  in  number,  and  named  numerically,  by  beginning 
at  the  great  one.  They  each  are  formed  by  three  bones  called  the 
phalanges,  with  the  exception  of  the  great  toe,  which  has  but  two  of 
them.  The  phalanges  are  distinguished  into  first,  second,  and  third. 
In  these  several  respects  the  toes  correspond  with  the  fingers.  (See 
Fig.  68.) 

Of  the  First,  or  G-reat  Toe. 

The  first  phalanx  of  the  great  toe  is  longer  and  much  larger  than 
any  other.  Its  base  is  large,  and  forms  a  deep  concavity  for  receiving 
the  end  of  the  first  metatarsal  bone.  Its  anterior  extremity  is  formed 
into  two  small  condyles,  for  being  received  into  the  second  phalanx. 
This  bone  is  broad  and  strong,  being  semi-cylindrical  above,  and  flat 
below. 

The  second  phalanx  is  very  much  like  the  second  phalanx  of  the 
thumb,  and  corresponds  with  the  third  of  the  other  toes,  but  is  much 
larger  than  any  of  them.  Its  base  is  broad  and  flat,  and  has  two 
superficial  cavities  for  the  condyles  of  the  first  phalanx.  The  ante- 
rior extremity  is  expanded  semicircularly,  and  converted  into  a  very 
scabrous  surface,  for  the  firmer  attachment  of  the  soft  parts  about  it. 
The  body  of  this  phalanx  is  constricted  in  the  middle,  rounded  above, 
and  flat  below. 


DEVELOPMENT  OF  THE  INFERIOR  EXTREMITIES.  241 

Connected  with  the  great  toe,  are  two  small  hemispherical  bones, 
lying  upon  the  trochlea  of  its  metatarsal  bone,  and  imbedded  in  the 
tendons  of  the  small  muscles  which  move  the  first  phalanx.  They  are 
the  sesamoids,  and  present,  superiorly,  an  articular  surface,  covered 
with  cartilage,  which  enters  into  the  composition  of  the  joint ;  and 
below,  a  rounded  surface,  which  has  nothing  remarkable. 

The  sesamoid  bones,  though  generally  appropriated  to  this  joint,  and  to 
the  corresponding  one  of  the  thumb,  are  yet  occasionally  found  else- 
where. For  example,  in  the  second  joint  of  the  same  toe ;  in  the  first 
joint  of  the  other  toes;  in  the  first  joint  of  the  fingers;  in  the  knee 
joint,  behind  each  condyle ;  and,  in  advanced  life,  in  tendons  where 
they  slide  upon  bones.  Ancient  luxations  give  a  disposition  to  their 
development  in  the  capsular  ligaments  of  the  ginglymous  joints,  of 
which  very  interesting  specimens  may  be  seen  in  the  Anatomical 
Museum. 

Of  the  Smaller  Toes. 

Their  phalanges  bear  a  general  resemblance  to  those  of  the  fingers, 
but  are  much  smaller  and  shorter. 

The  first  phalanges  are  successively  diminished  to  that  of  the  little 
toe,  and  are  almost  precisely  like  each  other.  Their  posterior  extremities, 
or  oases,  form  a  cavity  deeper  in  proportion  than  in  the  fingers,  for 
receiving  the  ends  of  the  metatarsal  bones.  The  anterior  extremities 
are  fashioned  into  two  small  condyles  for  forming  a  hinge-like  joint 
with  the  second  phalanges.  The  bodies  are  smaller  than  the  extremi- 
ties, more  rounded  and  narrower  than  in  the  fingers. 

The  second  phalanges  are  very  short,  the  extremities  being  so  near 
each  other  that  the  body  is  of  inconsiderable  length,  particularly  as 
regards  the  last  two,  where  it  forms  a  mere  line  of  separation.  The 
posterior  end  has  two  superficial  cavities  for  receiving  the  first  phalanx ; 
the  anterior  end  is  imperfectly  fashioned  into  two  little  condyles  for 
joining  the  third  phalanx. 

The  third  phalanx  has  a  well-formed  articular  surface  for  joining  the 
second.  The  anterior  extremity  is  rough,  for  the  attachment  of  the 
adjoining  soft  structure.  This  phalanx  of  the  fourth  and  fifth  toe  is 
frequently  very  imperfectly  developed,  being  a  mere  tubercle  with  an 
articular  face  at  one  end. 

The  structure  of  the  metatarsal  and  phalangial  bones  resembles  that 
of  the  other  long  bones.  Porous  and  cellular  at  the  extremities,  their 
bodies  are  composed  of  compact  lamellated  matter,  enclosing  a  cancel- 
lated texture. 


SECT.  IV. — OF  THE  DEVELOPMENT  OF  THE  INFERIOR  EXTREMITIES. 

The  comparatively  small  quantity  of  blood  which  is  sent  to  the  lower 
extremities  of  the  foetus  is  the  cause  of  their  not  being  so  large  in  pro- 
VOL.  I. — 16 


242  SKELETON. 

portion  to  the  upper,  at  the  time  of  birth,  as  they  are  subsequently. 
Our  wants  immediately  after  birth,  and  during  the  first  months  of  life, 
are  naturally  such  as  to  require  but  little  service  from  the  lower  extre- 
mities, in  which  is  seen  a  striking  correspondence  between  the  internal 
arrangements  of  the  animal  economy  and  its  actual  necessities;  or,  in 
other  words,  a  continued  and  rigid  adaptation  of  means  to  produce  a 
certain  effect. 

The  os  femoris  at  birth  presents  several  peculiarities.  Its  superior 
extremity  being  in  a  cartilaginous  state,  is  placed  more  at  a  right  angle 
to  the  body  of  the  bone  than  it  is  in  the  adult.  The  neck  is  short, 
which  by  diminishing  the  base  of  support  to  the  trunk  makes  the  pro- 
gression of  infants  more  tottering  and  infirm.  The  lower  extremity 
is  also  cartilaginous  and  large.  The  body  of  the  bone  has  but  a  very 
slight  degree  of  curvature,  which  likewise  increases  the  difficulty  of 
standing  and  walking  in  very  young  subjects.  The  patella  is  carti- 
laginous. 

In  the  leg  the  bodies  of  the  tibia  and  fibula  are  ossified,  but  their 
extremities  are  cartilaginous.  The  bones  of  the  tarsus,  with  the  excep- 
tion of  parts  of  the  os  calcis  and  of  the  astragalus,  are  cartilaginous. 
The  metatarsus  and  the  phalanges  are  ossified  in  their  'middle,  but  car- 
tilaginous at  their  extremities:  their  development  is  not  so  complete  as 
that  of  the  corresponding  bones  of  the  hand. 

About  the  fifteenth  year,  the  bones  of  the  lower  extremities  have 
very  nearly  the  same  forms  as  in  the  adult.  They  are  all  fully  ossified, 
with  the  exception  of  their  extremities  not  being  fused  or  joined  to 
their  bodies,  but  still  in  the  state  of  epiphyses;  and,  therefore,  sepa- 
rable either  by  boiling  or  long-continued  maceration.  Exclusively  of 
this  condition,  which  sometimes  remains  to  the  twentieth  or  twenty- 
fifth  year,  the  epiphyses  are  as  fully  ossified  as  at  any  subsequent 
period  of  life. 


SECT.  V. — ON  THE  MECHANISM  OF  THE  INFERIOR  EXTREMITIES  IN 
REGARD  TO  STANDING. 

The  os  femoris  is  well  adapted  by  its  shape  and  position  to  the 
erect  attitude.  The  curvature  which  its  body  makes  in  front  has  the 
effect  of  advancing  the  lower  part  of  it,  and  thereby  keeping  it  in  a 
line  with  the  centre  of  the  trunk ;  but  if  it  had  been  perfectly  straight, 
the  erect  position  would  have  been  maintained  with  great  difficulty, 
owing  to  the  centre  of  the  trunk  being  in  advance  of  this  bone.  Under 
the  latter  circumstances,  an  incessant  tendency  to  fall  forwards  would 
have  manifested  itself,  which  could  have  been  obviated  only  by  flexing 
the  ossa  femorum  very  much  at  the  hip  joint,  or  by  keeping  one  foot 
always  in  front  of  the  other.  Even  under  the  actual  arrangement  of 
the  skeleton,  when  muscular  support  is  withdrawn  from  it  suddenly,  it 
falls  forwards,  owing  to  the  weight  of  the  parts  anterior  to  the  spine 
being  greater  than  that  of  the  parts  posterior  to  it.  When  muscular 
action  is  weakened  or  badly  regulated,  the  same  tendency  to  fall  for- 
wards is  manifested;  children  continually  tumble  in  that  direction:  a 


MECHANISM  OF  THE  INFERIOR  EXTREMITIES.  243 

person  in  a  state  of  intoxication,  somewhat  short  of  the  entire  loss  of 
locomotion,  not  being  able  to  sustain  the  trunk  of  the  body  erect  by 
the  muscles  of  the  back,  inclines  forwards,  and  would  be  precipitated 
to  the  ground,  were  it  not  that  at  this  crisis  one  leg  is  automatically 
advanced,  so  that  the  base  of  support  is  much  augmented.  But  if  the 
individual  attempt  to  walk,  the  continued  necessity  of  keeping  a  large 
basis  of  support  to  prevent  the  body  from  falling  forwards,  urges  him 
into  a  slow  running  or  trotting  gait. 

The  arrangement  of  the  whole  upper  extremity  of  the  os  femoris  is 
also  highly  favorable  to  the  erect  attitude  and  to  locomotion.  The 
neck  of  the  bone,  by  its  length  and  oblique  position  in  regard  to  its 
body,  enlarges  transversely  the  base  of  its  support,  and  gives  great 
stability  in  preventing  the  trunk  from  falling  either  to  the  right  or 
left ;  while  it  contributes  at  the  same  time  to  the  facility  of  progres- 
sion, in  permitting  the  os  femoris  to  bend  forwards  and  backwards. 
The  lateral  or  transverse  extent  of  the  base,  thus  obtained,  cannot  be 
supplied  with  equal  effect  in  any  other  way,  as  a  certain  proportion 
between  the  diameters  of  the  pelvis  and  the  length  of  the  neck  of  the 
thigh  bone  is  indispensable.  In  females,  where  the  transverse  diameter 
of  the  pelvis  is  greater  than  in  males,  though  standing  is  equally 
secure  as  in  the  latter,  yet  their  progression  is  always  marked  by  a 
want  of  firmness  strongly  characteristic  of  the  sex.  The  strength  of 
the  articular  connection  of  the  os  femoris  with  the  innominatum  is  con- 
firmed by  the  acetabulum  being  placed  where  the  latter  is  reinforced 
by  the  linea-ilio  pectinea,  and  by  the  anterior  inferior  spinous  process  ; 
and  as  the  principal  weight  of  the  trunk  is  sustained  by  the  acetabulum, 
immediately  below  the  latter  process,  we  accordingly  find  it  at  this 
point  of  the  greatest  depth.  It  is  also  to  be  stated,  that  the  capsular 
ligament  at  this  part  is  stronger  than  elsewhere,  thereby  conforming 
strictly  to  the  general  purposes  of  the  articular  connection.  The  cap- 
sular ligament  is  assisted  by  the  ligamenturn  teres,  which,  by  arising 
from  the  lower  margin  of  the  acetabulum  and  passing  upwards  to  the 
head  of  the  os  femoris,  prevents  the  head  from  sliding  upwards,  while 
it  permits  it  to  swing  freely  backwards  and  forwards  in  its  socket. 

In  erection,  the  bones  of  the  leg  are  in  a  line  with  the  vertical  dia- 
meter of  the  trunk  :  in  this  respect  they  differ  very  materially  from  the 
os  femoris,  which  not  only  inclines  forwards  in  its  descent,  but  also  leans 
towards  its  fellow  internally,  and  almost  touches  it  at  the  knee.  This 
relative  position  of  the  leg  and  thigh  is  obtained  by  the  greater  length 
of  the  internal  condyle  of  the  os  femoris,  and  also  by  the  other  pecu- 
liarities of  form  in  the  latter ;  whereas  the  tibia  is  nearly  straight  in 
the  direction  of  its  long  diameter,  and  has  a  horizontal  articular  surface 
above,  whereby  it  and  the  os  femoris  make  an  entering  angle  externally 
and  a  salient  one  internally.  Under  common  circumstances,  the  weight 
of  the  trunk  is  transmitted  to  the  foot  exclusively  through  the  tibia, 
owing  to  the  fibula  not  entering  into  the  composition  of  the  knee-joint, 
and  not  being  sustained  by  any  bony  basement  at  its  inferior  part. 
The  fibula  is  principally  intended  for  the  origin  of  muscles,  and  for  the 


244  SKELETON. 

lateral  security  of  the  ankle  joint,  and  may  be  broken  without  the 
accident  suspending  either  erection  or  locomotion. 

The  position  and  shape  of  the  foot  concur  largely  in  the  general 
object  of  maintaining  the  human  being  in  the  erect  attitude.  Fixed 
at  a  right  angle  to  the  leg,  and  articulated  by  a  surface  in  the  centre 
of  its  most  solid  structure,  the  tarsus,  it  receives  the  weight  of  the  body 
perpendicularly  upon  the  astragalus.  The  latter  being  the  keystone  to 
the  arch,  diffuses  the  pressure  through  the  remainder  of  the  structure, 
so  that  the  whole  foot  is  planted  against  the  ground,  an  attitude  more 
fully  executed  by  man  than  by  any  other  animal.  The  tendency  of 
the  body  to  fall  forwards  requires  a  very  considerable  elongation  of  the 
foot  in  front  of  the  tarsus,  in  order  to  increase  the  extent  of  the  base 
of  support  in  that  direction.  We  accordingly  find  the  metatarsal  bones 
not  only  forming  bases  for  the  flexion  of  the  phalanges ;  but  also  by 
their  great  length,  by  the  flatness  of  the  articular  faces  which  they 
present  to  the  tarsus,  and  by  their  consequent  immobility  at  these 
points,  extending  and  securing  the  base  of  the  body  in  that  direction 
to  which  its  gravitation  most  inclines  it.  The  first  metatarsal  bone, 
though  corresponding  in  place  with  the  first  metacarpal,  is  very  unlike 
it  in  other  respects.  Of  predominating  magnitude,  but  parallel  with 
the  other  bones  and  immovable  at  its  base,  it  is  obviously  intended  for 
sustaining  the  body,  and  least  of  all  for  prehension  and  for  antagoniz- 
ing the  other  bones,  as  is  the  case  with  the  thumb. 

The  points  on  which  the  foot  is  particularly  pressed  when  we  stand, 
are  the  tuberosities  of  the  os  calcis,  the  tuber  of  the  base  of  the  last 
metatarsal  bone,  with  the  under  surface  of  the  cuboides,  and  the  anterior 
extremity  of  the  first  metatarsal  bone.  The  arch  of  the  foot,  upon 
which  this  depends,  may  be  considered  in  two  ways  :  one  is  in  the  longi- 
tudinal direction,  and  has  its  abutments  in  the  os  calcis  behind,  and 
in  the  ends  of  the  metatarsal  bones  in  front ;  the  other  is  transverse,  is 
but  slightly  elevated  externally,  indeed  almost  flat,  while  it  is  raised  to 
a  considerable  height  internally.  This  double  arrangement  is  eminently 
serviceable  in  many  respects  :  it  permits  a  concavity  in  which  the  mus- 
cles of  the  toes  may  repose  and  act  without  being  pressed  upon  by  the 
superincumbent  weight  of  the  body — it  also  permits  a  free  flow  of 
blood  and  of  nervous  energy  to  this  structure,  gives  a  very  elastic  base 
to  the  whole  body,  and  allows  itself  to  be  applied  to  such  inequalities  of 
surface  as  it  meets  with. 

It  has  been  agitated,  by  some  ingenious  inquirers  into  the  original 
condition  of  man,  whether  the  erect  attitude  is  natural  to  him  and  not 
the  result  of  an  advancement  in  civilization.  Independently  of  the 
proofs  derived  from  the  authentic  reports  of  travellers  concerning  the 
varieties  of  the  human  family,  from  none  of  whom  have  we  reason  to 
believe  that  the  latter  have  anywhere  been  found  adopting  habitually 
the  attitude  of  quadrupeds ;  there  are  evidences  derived  from  the  gene- 
ral mechanism  of  the  skeleton,  still  more  conclusive,  that  standing  is 
fully  natural  to  us.  For  example:  1st.  The  position  of  the  foramen 
magnum  occipitis,  evidently  farther  forwards  in  man  than  in  animals, 
indicates  that  his  voluminous  head  is  to  be  kept  in  equilibrium  by  a 


MECHANISM  OF  THE  INFERIOR  EXTREMITIES.  245 

vertical  line  of  support  near  the  centre  of  its  base.  2d.  The  ligamen- 
tura  nuchse,  weak  in  man,  is  strong  in  quadrupeds.  3d.  The  curva- 
tures of  the  spine  are  so  varied  as  to  diminish  the  tendency  to  fall 
forward  when  we  are  erect.  4th.  The  direction  of  the  orbits  of  the 
eyes,  which,  looking  forwards  when  we  stand,  and  enabling  the  eye 
to  apply  itself  to  a  vast  circumference,  would,  in  the  quadruped  posi- 
tion, be  directed  towards  the  ground,  and  thereby  have  the  sphere  of 
observation  reduced  to  a  few  yards.  5th.  The  opening  of  the  nostrils, 
when  we  stand,  permits  odors  to  ascend  easily  into  the  nose ;  in  the 
other  attitude,  this  opening  would  be  directed  backwards.  Such  are 
the  circumstances,  in  connection  with  the  head  only,  which  indicate  the 
necessity  of  the  biped  position  for  the  full  enjoyment  of  the  functions 
which  the  Creator  has  given  to  us.  But  there  are,  also,  others  equally 
evident  in  the  mechanism  of  the  extremities,  and  of  the  parts  of  the 
trunk  to  which  they  are  attached.  Thus,  1st.  The  breadth  of  the  pelvis, 
and  the  actual  obliquity  of  its  superior  strait,  in  regard  to  the  spine, 
prevent  us  from  falling  to  one  side,  arid  at  the  same  time,  bring  the 
lower  extremities  immediately  in  a  line  with  the  spine.  2d.  The  length 
of  the  neck  of  the  os  femoris,  and  the  size  of  its  condyles.  3d.  The 
articulation  of  the  knee,  which  permits  the  leg  to  be  brought  into  a  line 
with  the  os  femoris,  a  position  impracticable  in  quadrupeds.  4th.  The 
foot  being  articulated  at  a  right  angle  with  the  leg,  and  having  its  tar- 
sus and  metatarsus  so  well  developed.  5th.  The  predominance  of  the 
transverse  diameter  of  the  thorax  over  the  vertical,  which,  with  the 
great  length  of  the  clavicle,  and  the  shape  of  the  scapula,  unfit  the 
latter  for  assisting  much  in  progression.  6th.  The  shape  of  the  hand, 
calculated  to  seize  upon  objects,  but,  from  the  length  of  its  phalanges, 
not  suited  to  sustain  the  body.  Tth.  The  mode  of  articulation  at  the 
wrist,  which,  from  its  mobility  and  weakness  in  the  direction  to  which 
the  weight  of  the  body  would  be  applied  to  it,  could  not  be  brought  to 
support  it  advantageously.  And,  lastly,  the  great  disproportion  of 
length,  in  the  adult,  between  the  upper  and  lower  extremities,  when 
an  attempt  is  made  to  walk  like  the  quadruped. 

In  considering  the  skeleton  of  the  very  young  child,  it  is  worthy  of 
remark  how  closely  its  mechanism,  with  the  exception  of  the  head,  cor- 
responds with  the  habits  of  early  life.  A  spine,  nearly  straight,  and 
a  pelvis,  the  lateral  diameter  of  whose  cavity  is  so  small  that  the  trans- 
verse base  of  support  is  much  diminished,  render  erection  inconvenient. 
Lower  extremities  shorter  in  proportion  than  the  upper  ones,  having 
thigh  bones  nearly  straight ;  also,  the  articulation  of  the  knee  not 
admitting  of  a  full  extension  of  the  leg.  All  these  circumstances  prove 
that  the  quadruped  position,  inconvenient  and  intolerably  irksome  when 
continued  for  a  length  of  time  in  the  adult,  is  natural  to  the  young 
infant. 

The  space  between  the  ossa  femorum,  produced  by  the  breadth  of  the 
pelvis  and  the  length  of  their  necks,  and,  therefore,  always  consider- 
able above,  varies  below  in  different  individuals.  A  certain  distance 
at  the  latter  point  seems  to  be  indispensable  to  convenient  and  graceful 
progression.  Thus,  when  it  is  in  excess,  it  produces  the  deformity  called 


246  SKELETON. 

bandy  legs,  and  causes  a  tottering  gait,  such  as  may  be  mimicked,  at 
any  time,  by  walking  with  the  legs  in  a  state  of  abduction :  but,  when 
diminished,  it  is  called  knocked  knees,  and  interferes  with  the  firmness 
of  the  step,  by  causing  the  centre  of  gravity  to  pass,  alternately, 
through  the  internal  condyles  of  the  ossa  femorum,  instead  of  falling 
exactly  between  them. 

The  firmest  position  in  which  we  can  stand  is  that  in  which  the  feet 
are  perfectly  straight  and  parallel  with  each  other,  so  as  to  form  a 
square  base  for  the  support  of  the  trunk.  If  from  this  position  the  toes 
be  turned  either  inwards  or  outwards,  the  consequent  reduction  of  the 
antero-posterior  diameter  of  the  base  causes  less  resistance  to  the 
natural  inclination  of  the  trunk  forwards.  Whatever  may  be  the  grace 
and  the  ultimate  intention  of  the  first  position  in  dancing,  to  wit,  that 
of  having  the  feet  nearly  in  the  same  line,  with  the  heels  touching  and 
the  toes  outwards,  it  is  certainly  the  most  unfavorable  attitude  for  ease 
in  keeping  the  body  erect  that  can  be  adopted ;  for  the  base  of  support 
being  diminished,  both  by  the  length  of  the  body  of  the  os  calcis,  and 
by  that  of  the  foot,  anterior  to  the  ankle  joint,  the  trunk  is  continually 
inclining  either  forwards  or  backwards,  and  is  prevented  from  falling 
only  by  the  alternate  action  of  the  muscles  behind  and  in  front. 

When  we  are  upon  the  knees,  the  base  of  support  for  the  trunk  being 
entirely  withdrawn  in  front,  it  is  necessary,  in  order  to  maintain  the 
position  and  to  prevent  falling  forwards,  that  the  hip  joint  be  flexed  so 
as  to  throw  the  weight  of  the  body  entirely  behind  the  thigh  bones. 
The  position  is  one  of  so  much  restraint  and  fatigue  upon  the  muscles, 
that  it  can  be  maintained  for  a  long  time  only  by  some  artificial  sup- 
port in  front,  or  by  the  buttocks  falling  down  upon  the  legs,  and  resting 
against  them. 

The  position  we  assume  on  being  seated  in  a  chair,  is  the  easiest  of 
any  of  those  in  which  the  trunk  is  kept  erect  or  nearly  so.  The 
length  of  the  lever,  represented  by  the  whole  length  of  the  skeleton, 
is  then  diminished  one-half;  consequently,  any  preponderance  of  it  at 
particular  points,  above,  bears  with  less  force  upon  the  base.  The 
base  itself  is  much  augmented  by  the  amplitude  of  the  buttocks,  and 
by  the  horizontal  position  of  the  thigh  bones  in  front ;  and  may  be 
also  increased,  at  pleasure,  by  the  extension  of  the  legs.  If,  under 
such  circumstances,  the  trunk  of  the  body  be  slightly  advanced,  its 
equilibrium  is  so  easily  maintained  as  to  require  but  a  very  little  mus- 
cular action  to  continue  it.  The  most  exposed  part  of  the  base  is 
backwards ;  and,  if  the  trunk  be  kept  perfectly  erect,  there  is  some 
tendency  of  it  to  fall  in  that  direction.  Hence,  the  utility  of  backs  to 
seats,  and  the  fatigue  from  such  as  have  not. 


MECHANISM  OP  THE  INFERIOR  EXTREMITIES.  247 


SECT.  VI. — ON  THE  MECHANISM  OF  THE  INFERIOR  EXTREMITIES  IN 
REGARD  TO  LOCOMOTION. 

1.    Of  the  Motions  of  the  Thigh. 

These,  like  the  motions  of  the  os  humeri  upon  the  scapula,  consist  in 
extension,  flexion,  abduction,  adduction,  rotation,  and  circumduction  ; 
but  in  consequence  of  being  performed  upon  an  immovable  basis,  the 
acetabulum,  they  are  much  less  extensive.  In  order  that  they  may  be 
understood  well,  it  will  be  useful  to  assume  certain  points  of  reference 
in  the  os  innominatum  and  os  femoris.  These  are  the  trochanter  major, 
the  pubes,  and  the  anterior  superior  spinous  process  of  the  ilium.  In 
standing,  the  lower  external  part  of  the  trochanter  major,  where  it 
forms  a  bulge  on  the  side  of  the  thigh  bone,  is  on  a  horizontal  line  with 
the  upper  part  of  the  symphysis  pubis.  A  triangle,  described  by  lines 
drawn  from  the  anterior  superior  spinous  process  to  the  symphysis  pubis 
— from  the  latter  to  the  point  mentioned  of  the  trochanter,  and  from 
the  latter  to  the  anterior  superior  spinous  process,  will  be  nearly  a  rec- 
tangle, of  which  the  base  is  above,  and  the  shortest  side  behind. 

The  flexion  of  the  os  femoris  is  that  motion  in  which  its  lower  ex- 
tremity is  carried  forwards.  It  is  performed  with  great  ease  and  free- 
dom, in  consequence  of  the  arrangement  of  the  articular  surfaces  of  the 
bones  and  of  the  capsular  ligament.  The  head  revolves  freely  in  the  ace- 
tabulum, the  ligamentum  teres  is  put  into  a  slight  tension,  and  the  end  of 
the  trochanter  major  approaches  the  sciatic  notch.  The  extreme  point  of 
this  motion  is  the  one  preserved  by  the  os  femoris  of  the  foetus  in  utero. 

Extension  is  the  reverse  of  flexion.  When  the  latter  has  been  per- 
formed, extension  restores  the  thigh  bone  to  its  vertical  position,  and 
carries  it  some  degrees  farther,  but  cannot  be  executed  to  the  same 
extent  behind,  that  flexion  is  in  front.  When  pushed  to  an  extreme,  it 
brings  the  trochanter  major  under  the  anterior  inferior  spinous  process 
of  the  ilium,  and  the  round  ligament  is  put  very  much  upon  the  stretch ; 
it  is  finally  arrested  by  the  lower  part  of  the  neck  of  the  os  femoris 
lodging  against  the  posterior  elevated  margin  of  the  acetabulum,  and 
by  the  thickened  part  of  the  capsule,  in  front  and  above,  being  so 
much  distended  as  not  to  yield  farther  without  laceration. 

Abduction  is  the  act  by  which  the  thigh  bones  are  separated.  When 
carried  to  an  extreme,  the  under  part  of  the  head  of  the  os  femoris 
leaves  the  acetabulum,  and  distends  very  forcibly  the  capsular  ligament 
at  this  point.  The  superior  fasciculus  of  the  round  ligament  is  strongly 
extended;  but  the  inferior  fasciculus  is  kept  easy,  and,  indeed,  some- 
what relaxed.  This  motion  is  arrested  by  the  trochanter  major  striking 
against  the  ilium ;  without  which  it  would  be  much  more  extensive,  as 
the  capsular  ligament  is  strained  at  its  weakest  point,  and  relaxed  at 
the  strongest. 

Adduction  is  the  reverse  of  the  last.  The  muscles  which  produce 
it,  the  adductors,  from  their  situation  and  course,  are  unable  to  give  an 


248  SKELETON. 

extent  to  this  motion  much  beyond  the  act  of  reinstating  the  thigh 
when  it  has  been  adducted.  In  this  respect  they  are  much  less  influ- 
ential than  the  great  pectoral  muscle  which  adducts  the  os  humeri. 
The  articular  surfaces  of  the  bones  are  suited  to  a  much  greater  lati- 
tude of  this  movement,  but  it  is  arrested  both  by  a  deficient  power  in 
the  muscles,  and  by  the  strong  upper  part  of  the  capsular  ligament 
being  put  upon  the  stretch. 

Circumduction  is  the  regular  succession  in  a  circle  of  the  four  pre- 
ceding motions,  and  is  much  less  extensive  in  the  os  femoris  than  in 
the  os  humeri,  for  the  reasons  stated.  The  centre  of  the  circle,  or 
cone,  thus  described,  is  the  head  of  the  bone,  and  it  is  much  more  ex- 
tensive anteriorly  and  externally,  than  posteriorly  and  internally. 

Rotation,  owing  to  the  length  of  the  neck  of  the  os  femoris,  is  ex- 
tremely well  marked,  and  is  indicated  by  the  trochanter  major  moving 
backwards  and  forwards.  The  radius  of  the  circle  thus  described  is 
the  distance  between  the  centre  of  the  head  of  the  os  femoris  and  the 
bulging  external  part  of  the  trochanter  major.  The  rotation  outwards 
or  backwards  is  more  fully  and  easily  performed  than  the  reverse, 
owing  to  the  number  and  favorable  position  of  the  muscles  causing  it, 
many  of  which  are  specially  appropriated  to  its  production,  and  some 
others  partially  so.  This  movement  is  arrested  by  the  neck  of  the 
bone  striking  against  the  acetabulum  behind,  and  by  the  tension  of  the 
capsular  ligament  in  front.  Rotation,  forwards,  having  but  few  mus- 
cles to  produce  it,  and  they  neither  specially  devoted  to  it,  nor  acting 
very  advantageously  for  the  purpose,  is  arrested  by  the  neck  of  the 
bone  striking  against  the  fore  part  of  the  acetabulum ;  by  the  tension, 
behind,  of  the  capsular  ligament,  and  also,  by  that  of  the  ligamentum 
teres.  When  the  convexity  and  the  neck  of  the  os  femoris  look  di- 
rectly forwards,  it  is  indicated  by  the  great  toe  pointing  in  the  same 
direction. 

2.  Of  the  Motions  of  the  Leg. 

The  movement  of  the  leg  upon  the  thigh  is  that  of  flexion,  of  exten- 
sion, and  a  very  partial  degree  of  rotation. 

In  flexion,  the  head  of  the  tibia  slides  backwards  upon  the  con- 
dyles  of  the  os  femoris,  which  are  prolonged  behind,  for  the  purpose 
of  extending  this  motion.  It  is  checked,  when  carried  to  an  extreme, 
by  the  posterior  margin  of  the  tibia  striking  against  the  os  femoris, 
and  by  the  tension  of  the  ligament  of  the  patella.  In  the  mean 
time,  the  lateral,  the  crucial,  and  the  posterior  ligaments  are  relaxed. 
The  patella,  always  stationary,  and  at  the  same  relative  distance  in 
regard  to  the  head  of  the  tibia,  slides  downwards  upon  the  trochlea  of 
the  os  femoris,  and  in  the  flexed  position  sinks  between  the  condyles, 
so  as  to  come  in  contact  with  the  ligamentum  mucosum. 

In  extension,  the  patella  rises  upon  the  condyles,  and  becomes  pro- 
minent; the  lateral  ligaments  are  rendered  somewhat  tense,  and  the 


MECHANISM  OF  THE  INFERIOR  EXTREMITIES.  249 

motion  is  finally  checked,  by  the  resistance  of  the  crucial  and  of  the 
posterior  ligaments  of  the  articulation. 

The  rotation  of  the  bones  of  the  leg  can  only  be  performed  when 
they  are  flexed,  and  the  ligaments,  generally,  thereby  relaxed,  in  which 
position  a  very  limited  motion,  inwards  and  outwards,  is  perceptible. 
The  motion  outwards  is  the  more  extensive  of  the  two,  in  consequence 
of  the  arrangement  of  the  crucial  ligaments,  which  are  separated  from 
each  other  by  it.  The  motion,  inwards,  is  limited  by  these  ligaments 
being  brought  immediately  by  it  into  close  and  resisting  contact  with 
each  other.  In  either  case,  however,  the  posterior  and  the  lateral  liga- 
ments all  contribute,  ultimately,  to  arrest  the  motion. 

In  all  these  conditions  of  the  leg,  the  semilunar  cartilages  slide 
somewhat  upon  the  head  of  the  tibia. 

The  articulation  between  the  tibia  and  the  fibula  is  such  as  to  admit 
of  no  motion  whatever  below;  but,  above,  a  limited  sliding  backwards 
and  forwards  is  performed  by  the  fibula  upon  the  tibia.  This  move- 
ment is  made  more  perceptible  in  cases  of  extreme  emaciation,  and  in 
general  relaxation  of  the  muscular  system. 

3.   Of  the  Motions  of  the  Foot. 

The  general  motions  of  the  foot  upon  the  bones  of  the  leg  are 
flexion,  extension,  and  an  inconsiderable  inclination  inwards  and  out- 
wards. 

In  flexion,  the  astragalus  rolls  backwards  in  the  articular  cavity 
formed  by  the  tibia  and  the  fibula,  and  is  arrested  by  the  anterior  upper 
part  of  the  astragalus  coming  in  contact  with  the  articular  margin  of 
the  tibia.  The  ligamentous  fibres  and  the  synovial  membrane,  in  front 
of  the  articulation,  are  relaxed  ;  those  behind  are  in  a  state  of  tension, 
as  well  as  the  tendo-Achillis,  and  the  other  tendons  there.  Luxation 
from  an  excess  of  this  motion  is  almost  impossible. 

In  extension,  the  foot  is  brought  with  the  point  downwards,  so  as  to 
have  its  upper  surface  almost  on  a  line  with  the  bones  of  the  leg.  The 
astragalus  glides  forwards;  the  tendons,  on  the  back  of  the  joint,  are 
very  much  relaxed.  The  joint  itself  is  in  a  state  the  reverse  of  the 
preceding. 

In  the  lateral  motions,  the  sole  of  the  foot  is  caused  to  present  itself 
either  obliquely  inwards  or  outwards,  whereby  it  may  be  accommodated 
to  any  inclined  surface  on  which  we  walk.  The  first  position  is  checked 
by  the  internal  malleolus,  and  by  the  tension  of  the  external  lateral  liga- 
ments ;  the  second,  by  the  external  malleolus,  and  by  the  tension  of 
the  internal  lateral  ligament.  These  motions  constitute  the  adduction 
and  the  abduction  of  the  foot,  and  by  a  regular  succession  with  its 
flexion  and  extension,  communicate  a  very  limited  and  embarrassed 
species  of  circumduction. 


250  SKELETON. 

The  bones  of  the  tarsus,  for  the  most  part,  have  a  very  obscure 
motion  upon  each  other,  with  the  exception  of  the  articulation  between 
the  astragalus  and  the  scaphoides,  and  between  the  os  calcis  and 
cuboides.  At  these  points  the  movement  upwards  and  downwards 
makes  a  sort  of  flexion  and  extension  of  the  fore  part  of  the  foot,  which 
is  very  distinct.  A  species  of  twisting,  or  oblique  gliding,  is  also 
slightly  perceptible  there. 

The  bones  of  the  metatarsus  are  susceptible  of  a  slight  elevation  and 
depression,  which,  almost  imperceptible  at  their  bases,  become  suffi- 
ciently obvious  at  their  anterior  extremities.  They  also  may  be 
slightly  approximated,  at  their  fore  parts,  by  the  action  of  muscles, 
and  by  external  compression.  When  the  weight  of  the  body  is  thrown 
upon  them,  they  separate  from  each  other,  and  the  metatarsus  loses,  in 
some  degree,  the  arched  form  of  its  anterior  extremity  below. 

The  phalanges  of  the  toes  have  the  same  motions  with  those  of  the 
fingers,  except  that  they  are  more  restricted.  The  first  of  them,  there- 
fore, perform  flexion,  extension,  adduction,  abduction,  and  circumduc- 
tion ;  the  last  two  have  only  flexion  and  extension.  The  extension  of 
the  first  phalanges  is  more  extensive  than  their  flexion,  from  whence 
results  an  important  advantage  in  walking  or  in  standing  upon  the 
toes.  The  shortness  of  the  second  and  third  phalanges  of  the  small 
toes,  together  with  the  thickness  of  the  sole  of  the  foot  contiguous  to 
them  in  their  extreme  flexion,  causes  them  rather  to  be  doubled  upon 
themselves  than  on  the  sole  of  the  foot. 

On  the  Greneral  Motions  of  the  Lower  Extremities. 

These  may  be  resolved  into  three ;  walking,  running,  and  leaping. 

In  walking,  though  the  first  step  may  be  taken  in  a  variety  of  rela- 
tive positions  of  the  lower  extremities  to  each  other,  yet  it  will  make 
the  investigation  more  clear  to  suppose  the  individual  standing  erect, 
with  the  two  feet  precisely  on  the  same  plane,  and  giving  equal  sup- 
port to  the  trunk.  The  first  step  is  then  taken,  by  detaching  the  foot 
of  one  side  from  the  ground;  in  order  to  do  which,  the  thigh  is  bent 
upon  the  trunk,  the  leg  upon  the  thigh,  and  the  limb  by  being  thus 
elevated  becomes  shorter.  At  this  period  the  ankle  joint  remains  at 
rest,  with  a  slight  inclination  of  the  toes  downwards.  By  the  subse- 
quent relaxation  of  the  muscles  of  the  limb  advanced,  with  an  inclina- 
tion of  the  trunk  to  the  same  side,  the  limb  is  caused  to  descend  upon 
the  ground.  These  are  the  only  motions  when  the  step  is  short  and 
easy;  but,  when  a  long  stride  is  taken,  by  which  the  limb  is  put  very 
much  in  advance  of  its  fellow,  in  order  to  bring  it  to  the  ground,  the 
pelvis  is  caused  to  rotate  forwards  on  the  head  of  the  stationary  thigh 
bone,  whereby  the  trunk  of  the  body,  instead  of  presenting  the  sternum 
forwards,  has  it  turned  to  one  side. 

When  a  step  has  been  taken  so  as  to  leave  one  inferior  extremity 
advanced  before  the  other,  for  example  the  left,  the  limb  behind  is 
brought  forward  by  the  following  mechanism.  The  left  foot  remaining 
fixed,  becomes  the  point  of  support  to  the  trunk;  and  the  right,  which 


MECHANISM  OF  THE  INFERIOR  EXTREMITIES.  251 

is  behind,  is  elevated  successively,  from  the  heel  to  the  toes,  by  the 
action  of  the  muscles  on  the  back  of  the  leg,  and  rests  upon  the  pha- 
langes. The  effect  of  this  position  is  to  elongate  the  right  inferior 
extremity  to  the  amount  of  the  distance  between  the  fore  part  of  the 
ankle  joint  and  the  anterior  extremity  of  the  metatarsus,  whereby  that 
side  of  the  pelvis  is  pushed  forwards,  and  a  rotation  in  advance  im- 
pressed upon  it.  By  the  latter  impulse,  the  foot  of  that  side  is  wholly 
detached  from  the  ground,  the  thigh  being  flexed  at  the  same  moment 
at  the  hip  joint,  and  the  leg  flexed  at  the  knee,  the  whole  extremity  is 
carried  forward  and  fixed  upon  the  ground,  after  the  manner  described 
in  the  first  step.  Ordinary  progression  results,  then,  from  the  regular 
succession  of  the  last  motion  in  the  two  extremities.  In  regard  to  the 
impulsion  of  the  pelvis  from  the  foot  behind,  this  will  probably  take 
place  in  every  case,  more  or  less;  it  may,  however,  be  reduced  very 
much  by  a  certain  extent  of  flexion  at  the  knee  joint;  and  the  want  of 
it  not  be  felt,  because  other  powers  concur  to  produce  the  same  impul- 
sion; as  certain  muscles,  and  also. the  momentum  of  swinging  the  lower 
extremity  forward. 

An  equality  of  length  in  the  lower  extremities  is  indispensable  to 
graceful  and  regular  progression.  If  one  of  them  be  shortened  from 
any  cause  whatever,  it  is  manifested  in  the  gait,  by  an  unusual  sinking 
of  the  pelvis  on  the  defective  side,  at  the  moment  the  foot  is  brought  to 
the  ground,  arid  from  the  continuity  of  the  pelvis  with  the  upper  parts 
of  the  body,  a  considerable  lateral  inclination  is  communicated  to  the 
latter  in  the  same  instant.  The  pains  frequently  taken  to  conceal  this 
defect  disguise  it  very  imperfectly,  unless  the  shortness  be  only  such  as 
may  be  supplied  by  a  shoe  with  a  sole  thicker  than  that  of  the  other  foot. 
Where  the  shortness  arises  from  luxation  upwards  of  the  os  femoris,  a 
crutch  is  the  best  substitute  for  sustaining  that  side  of  the  pelvis. 

In  running,  the  position  of  the  feet  is  somewhat  different  from  what 
it  is  in  walking ;  they  are  extended  so  as  to  support  the  trunk  on  the 
phalanges  alone,  instead  of  on  their  soles :  whereby  a  double  advan- 
tage is  obtained,  that  of  keeping  the  lower  extremities  at  their  greatest 
possible  length,  and  also  of  enabling  them  to  detach  themselves  quickly 
from  the  ground.  The  velocity  here  is  the  principal  difference  between 
it  and  walking,  yet  there  are  some  peculiarities. 

The  trunk  of  the  body  is  kept  continually  and  largely  inclined  for- 
wards, which  enjoins  the  necessity  of  a  quick  successive  advance  of 
the  lower  extremities  to  prevent  it  from  falling.  This  position,  also, 
by  advancing  the  bony  points,  from  which  arise  several  of  the  muscles 
used  in  the  extension  of  the  thigh,  removes  these  muscles  more  from 
the  line  of"  their  contraction,  and  thereby  enables  them  to  act  more 
advantageously  arid  promptly.  As  each  pace  on  these  occasions  is 
taken  to  the  fullest  stretch,  the  pelvis  is  rotated  forwards  from  side  to 
side,  alternately  upon  the  head  of  the  os  femoris,  which  may  be  fixed 
at  the  time.  The  face  being  directed  forwards,  whatever  rotation  in 
the  vertebrae  can  occur,  is  then  performed.  As  the  pelvis  communi- 
cates its  motions  to  the  trunk,  so  the  latter  carries  its  own  to  the  upper 
extremities ;  which  are  thereby  slung,  alternately,  backwards  and  for- 
wards, and  are  brought,  continually,  to  adjust  the  centre  of  gravity, 
which  is  then  more  in  danger  of  being  lost  than  in  ordinary  walking. 


252  SKELETON. 

The  ascent  of  an  inclined  plane,  either  by  walking  or  running,  is 
attended  with  unusual  fatigue  and  difficulty,  for  the  following  reasons: 
In  order  to  advance  the  thigh,  it  is  necessary  to  give  it  great  flexion  at 
the  hip-joint;  the  knee  must  also  be  bent  in  an  equal  degree,  and  the 
foot  be  flexed,  in  order  to  adjust  it  to  the  surface  against  which  it 
reposes.  To  bring  forward  the  other  extremity,  it  requires  an  equal 
flexion  at  the  hip  and  knee;  besides  which,  its  heel  being  below  the 
phalanges,  the  foot  must  perform  a  full  rotation  at  the  ankle  joint. 
The  difficulty  is  somewhat  diminished  by  stepping  only  on  the  pha- 
langes. As,  in  these  cases,  the  trunk  of  the  body,  to  preserve  its 
equilibrium,  must  be  inclined  forwards,  there  are  certain  acclivities, 
which,  though  they  furnish  a  base  sufficiently  large  for  the  foot,  are 
yet  impracticable  from  not  allowing  the  trunk  to  be  thrown  forwards. 

The  descent  of  an  inclined  plane  is  more  easy,  because  it  requires 
but  little  flexion  in  the  articulations  mentioned  to  bring  the  extremity 
behind  on  a  line  with  that  in  front ;  and  its  subsequent  descent  is  pro- 
duced by  keeping  it  almost  straight  and  shortening  the  extremity  which 
is  fixed.  Running  is  then  attended  with  some  inconveniences,  for  the 
impulsion  forwards  which  this  motion  communicates  to  the  trunk, 
assisted  by  the  inclination  of  the  plane  in  that  direction,  determines  a 
fall  inevitably  without  a  successively  accelerated  advance  of  the  hind 
leg.  We  see  frequently,  in  the  descent  of  a  very  inclined  hill,  a  step, 
at  first  guarded  and  leisurely  taken,  converted  unavoidably  into  a  full 
run  to  prevent  the  body  from  being  precipitated  forwards  to  the 
ground. 

In  jumping,  the  whole  body  is  projected  abruptly  from  the  ground 
either  in  a  vertical  or  oblique  direction. 

In  the  first,  the  lower  extremities  are  shortened  by  a  general  flexure 
of  their  articulations  ;  and  by  a  very  sudden  and  simultaneous  extension 
of  them,  the  resistance  of  the  ground  causes  the  whole  frame  to  mount 
upwards  till  its  gravitation  causes  the  momentum  to  cease;  it  then 
descends,  on  the  same  principle  with  projectiles  generally.  In  the 
oblique  leap  there  is  the  same  flexion  in  all  the  articulations  of  the 
lower  extremities,  with  the  addition  of  an  inclination  forwards  of  the 
trunk.  At  the  moment  when  the  limbs  straighten  themselves,  the  trunk 
is  projected,  not  only  upwards,  but  forwards,  owing  to  its  inclination, 
and  describes  in  its  ascent  and  descent  a  parabola.  In  this  effort,  the 
space  traversed  will  be  more  considerable,  if  a  previous  horizontal 
momentum  has  been  communicated  to  the  trunk,  by  running  several 
steps  before  the  leap  be  made. 

The  more  oblique  the  leap  is,  the  greater  will  be  its  extent,  to  effect 
which  the  trunk  must  be  inclined  proportionably  forwards.  But  to 
obtain  this  inclination  without  falling,  it  is  necessary  for  one  of  the 
lower  extremities  to  be  very  much  advanced  at  the  moment  of  springing 
with  the  other,  so  as  to  convert  the  motion  into  a  very  long  step. 
With  this  position  of  the  lower  extremities,  a  much  longer  space  can  be 
cleared  than  if  they  were  kept  together.1 

1  For  a  further  exposition  of  the  principles  of  locomotion,  see  Joh.  Alph.  Burelli  de  Motu 
Animalium,  1710.  Haller,  Element.  Physiol.  torn.  iv.  1757.  Bichat,  Anat.  Descript.  1801. 
Earth ez,  Nouvelle  Mechanique  des  Mouvemens  de  1'Homme  et  des  Animaux,  1798.  En- 
cyclop.  Anat.  t.  ii.  Paris,  1843. 


BOOK  I. 


PART  III. 

CARTILAGINOUS,  FIBROUS,  FIBRO-CARTILAGINOUS  AND  SYNO- 

VIAL  TISSUES. 

CHAPTER  I. 
HISTOLOGY  OF  THE  CARTILAGINOUS  SYSTEM. 

CARTILAGES  (Cartilagines^  Systeme  Cartilagineux],  besides  being 
the  nidus  for  bone  in  forming  the  skeleton,  supply  permanently  the 
place  of  bone  in  many  parts  of  the  human  body,  as  in  the  space  be- 
tween the  ribs  and  the  sternum,  in  the  larynx,  in  the  external  ear,  in  the 
nose,  and  elsewhere.  They  are  also  to  be  found  in  all  the  movable, 
and  in  several  of  the  immovable  articulations.  Wherever  placed,  they 
may  be  recognized  by  their  whiteness,  by  their  flexibility,  by  their 
great  elasticity,  and  by  a  hardness  only  short  of  that  of  the  bones. 
There  are  many  animals  whose  skeletons  are  entirely  cartilaginous,  as 
the  chondropterous  or  cartilaginous  fishes,  so  excellent  a  substitute  is 
cartilage  for  bone. 

From  the  preceding  distribution  of  the  cartilaginous  tissue,  it  is 
divided  into  articular  cartilages,  or  those  which  cover  the  ends  of  bones 
in  forming  the  joints ;  and  into  the  cartilages  of  substitution,  or  those 
that  supply  the  place  of  bone,  so  as  to  form  a  flexible  skeleton  or  basis 
for  the  superimposed  structure.  The  instances  of  the  latter  are,  for 
the  most  part,  fibre-cartilages  or  cartilage  and  ligament  in  union. 

Cartilages  have  neither  medullary  canals  nor  areolse  in  them  like 
those  of  bones.  The  immersion  of  them  in  boiling  water  dissolves 
into  a  jelly,  such  as  are  found  upon  the  articular  surfaces  of  the 
bones,  and  a  few  others  ;  but  such  as  supply  the  place  of  bone, 
though  softened  by  the  process,  are  not  rendered  by  any  means  so 
gelatinous. 

Their  chemical  analysis,  according  to  Mr.  I.  Davy,  is  gelatin  44. 5; 
water  55;  phosphate  of  lime  0.5.  The  testimony  of  different  experi- 
menters, upon  the  latter  point,  does  not  coincide,  and  their  results  must 
vary  according  to  the  kind  of  cartilage,  and  the  period  of  life. 

Cartilages  are  composed  of  a  tissue  exclusively  their  own,  and  of 


254  SKELETON. 

parts  which  they  have  in  common  with  other  organs.  The  first  has 
some  very  distinguishing  properties.  It  resists  putrefaction,  either 
with  or  without  maceration,  longer  than  any  other  tissue,  except  the 
bones.  In  the  midst  of  gangrene  it  preserves  its  appearance  almost 
unchanged.  Boiling  gives  it  a  yellow  color,  causes  it  to  swell,  and,  if 
protracted,  the  gelatinous  portion  is  dissolved.  When  dried,  they 
become  of  a  semi-transparent  yellow,  diminish  in  bulk,  and  lose  their 
elasticity  ;  in  these  respects  resembling  ligaments  and  tendons.  From 
their  bibulous  structure  they  very  readily  swell  out  again  upon  immer- 
sion in  water. 

Cellular  substance  exists,  in  very  small  quantities,  in  cartilage,  and 
is,  therefore,  not  readily  demonstrated  ;  it  is,  however,  made  manifest 
by  maceration,  and  by  the  action  of  boiling  water  :  the  latter,  by  dis- 
solving the  gelatinous  portion,  leaves  a  membranous  and  cellular  sub- 
stance. It  is  also  stated  that  in  certain  diseases,  the  gelatinous  portion 
being  less  abundantly  secreted,  the  cellular  is  left  in  a  soft  spongy 
condition. 

In  a  healthy  state,  no  blood-vessels  can  be  seen  in  articular  cartilages ; 
yet  there  are  the  strongest  proofs  of  a  species  of  'circulation  going  on 
in  them,  either  by  very  fine  capillary  vessels,  or  an  interstitial  absorp- 
tion. All  experienced  anatomists  have  seen,  in  subjects  affected  with 
jaundice,  the  entire  cartilaginous  system  losing  its  brilliant  whiteness, 
and  becoming  of  a  light  yellow.  The  cartilages,  or  rather  fibro-carti- 
lages,  which  supply  the  place  of  bone,  and  act  in  that  way,  as  parts 
of  the  skeleton,  exhibit  a  decided  presence  of  blood-vessels  in  small 
quantity  and  not  difficult  to  be  detected  in  an  advanced  period  of  life 
by  minute  injection,  or  by  a  spontaneous  congestion  of  blood  in  them ; 
but  in  extreme  old  age,  when  ossification  invades,  to  a  variable  extent, 
all  of  these  structures,  they,  like  the  primary  ossific  cartilage,  have  a 
free  evolution  of  blood-vessels,  easily  seen  by  the  naked  eye.  This  is. 
especially  the  case  in  the  cartilages"  of  the  ribs,  whose  ossification  is 
very  common,  and  generally  found  most  abundant  near  the  centre,  but 
seldom  so  perfect  as  in  the  regular  bones,  there  being  a  very  large 
proportion  of  gelatin  for  the  amount  of  calcareous  matter. 

Neither  absorbents  nor  nerves  have  been  traced  into  cartilages,  and 
it  is  not  possible  to  prove  conclusively  their  existence  by  the  circum- 
stances of  disease.  We  only  know  that  in  inflammations  of  the  joints, 
terminating  by  anchylosis,  the  cartilages  are  removed ;  and  that  in 
some  cases,  even  without  evident  inflammation,  the  cartilage  disappears 
from  a  joint  as  if  it  had  been  worn  away.  Ulcerations  of  the  ary  tenoid 
cartilages  are  spoken  of  as  common  by  the  French  anatomists ;  and  I 
have,  since  the  first  edition  of  this  work,  seen  several  instances  in 
chronic  Laryngitis ;  but  it  has  not  occurred  to  me  to  see  any  others 
unequivocally  in  this  state.1  It  must,  however,  be  borne  in  mind,  that 
these  approximate  like  the  costal  cartilages  to  the  fibro-cartilaginous 
system.  Possessed  of  no  animal  sensibility  in  the  natural  state,  it  is 
doubtful  whether  cartilages  ever  have  it,  or  can  inflame,  as  the  pains 
in  inflammations  of  the  joints  may  arise  from  the  synovial  membranes. 

In  the  embryo,  the  osseous  and  the  cartilaginous  systems  are  con- 

1  The  late  Dr.  Physick's  experience  is  al.so  the  same  with  my  own. 


THE  CARTILAGINOUS  SYSTEM.  255 

founded,  so  as  to  present  a  homogeneous  mucous  or  pulpy  appearance; 
they  only  become  distinct  by  the  deposit  of  calcareous  matter  in  the 
bones :  when  the  latter  are  somewhat  advanced,  the  cartilages,  which 
are  to  remain  such  have  also  additional  consistence,  and  more  of  a 
proper  cartilaginous  look ;  but  the  appearance  is  generally  unsatis- 
factory, by  which  one  can  learn  to  distinguish  the  cartilages  that  are 
to  remain  such  from  the  cartilaginous  rudiments  of  the  bones.  The 
following  circumstance,  however,  is  pointed  out  by  Bichat :  in  the 
cartilages  of  ossification,  there  is  a  vascular  net-work  between  the 
cartilage  and  the  ossification  which  has  occurred,  and  owing  to  the  in- 
terposition of  it,  the  two  may  be  easily  separated.  But  in  the  perma- 
nent cartilage,  this  net-work  does  not  exist  between  the  proximate  sur- 
faces of  the  bone  now  formed  and  of  the  cartilage,  consequently  they 
adhere  with  a  tenacity  not  admitting  of  an  exact  separation  from  one 
another. 

The  organic  structure  of  every  cartilage  consists  in  a  transparent 
amorphous  substance,  or  matrix,  with  cells  or  vesicles  numerously  in- 
terspersed through  it.  These  vesicles  are  ovoidal  or  of  a  notched 
lenticular  shape,  somewhat  resembling  a  broad  bean.  In  the  mature 
cartilage  the  parietes  of  such  cells  cannot  be  well  distinguished  from 
the  amorphous  substance,  which  in  this  state  is  called  the  hyaline  or 
vitreous  cartilage.  The  cells  themselves,  now  called  Cartilage  corpus- 
cles, are  filled  with  a  softer  substance,  in  which  their  nuclei  repose 
apparently  for  the  most  part  unattached  to  the  walls  of  the  cells,  but 
not  universally  so.  The  nuclei  have  within  them  nucleoli. 

In  the  mature  state,  cartilages  present  great  diversity  in  their  inti- 
mate texture,  but  while  in  a  state  of  evolution  they  are  much  alike. 
Thus,  the  structure  originates  in  cells  as  the  rest  of  the  body ;  but 
between  the  cells  or  vesicles  is  a  larger  proportion  of  hyaline  or  amor- 
phous matter.  The  latter  increases  with  the  growth  of  the  cells,  and 
new  cells  spring  out  from  cytoblasts  or  germinal  particles  existing  in  it. 
The  early  cells  are  much  disposed  to  throw  off  shoots  from  their  nuclei, 
and  thus  groups  of  cells  are  formed. 

Permanent  cell  cartilages  of  the  above  description  are  seen  in  the 
septum  narium,  alse  and  point  of  the  nose,  eyelids,  external  ear,  Eusta- 
chian  tube,  larynx  excepting  epiglottis,  and  cornicula  laryngis,  trachea 
and  its  branches,  the  articular  cartilages,  costal,  and  ensiform  of  the 
sternum ;  but  the  cartilage  corpuscles  are  far  from  being  abundant  in 
them. 

In  transient  cell  cartilage,  that  which  is,  for  example,  to  be  the  nidus 
for  bone,  the  vesicles  or  cells  are  very  numerous  in  comparison  with  the 
matrix,  and  vary  in  size  as  well  as  in  shape,  some  being  round,  others 
oval,  and  others  compressed  ovoidal.  They,  as  stated  in  regard  to  the 
process  of  osteogeny,  being  first  of  all  irregular  in  position,  yet  finally 
disposed  into  a  sort  of  columnar  or  shafted  arrangement,  the  ends  of 
which  point  to  the  surface  of  ossification. 

The  cells  of  cartilages  vary  considerably,  according  to  the  cartilages 
themselves,  in  regard  to  both  size,  shape,  and  number.  In  the  carti- 
lages of  the  ribs  they  are  from  g^th  to  ^J^th  of  an  inch  in  diameter, 
while  in  the  articular  cartilages  they  are  from  iV^th  to  ^J0th  of  an 
inch. 


256  SKELETON. 

x 

If  the  base  of  cartilage  be  pure  and  transparent,  the  cartilage  is 
•white  or  of  a  bluish  white ;  if,  on  the  other  hand,  the  fibrous  element 
prevail,  then  the  cartilages  have  a  yellowish  tint.  The  cartilages 
which  have  a  homogeneous  base  are  called  True — and  those  with  a 
fibrous  base  are  called  False.  There  are,  however,  several  -of  these 
bodies  so  much  on  the  transition  line  that  the  distinction  is  observed 
with  some  difficulty,  and  there  are  changes  depending  upon  the  pro- 
gress of  life  from  early  infancy  to  old  age  which  also  interfere  with 
this  classification. 

Microscopic  observers  have  remarked1  that  the  closest  resemblance 
exists  between  the  structure  of  cartilages  and  of  vegetables,  so  that  an 
exact  identity  prevails  in  regard  to  the  form,  the  grouping  and  even 
the  mode  of  origin  of  their  vesicles  or  cells.  In  all  the  mammalia,  the 
state  of  ossific  cartilage  is  uniform,  this  condition  being  varied  only 
according  to  their  degree  of  maturity  for  the  reception  of  bony  de- 
posits. The  permanent  cartilages  vary  less  in  their  appearance  at 
different  epochs,  and  their  cells  discovered  by  Purkinje  are  more  closely 
packed  as  the  cartilage  is  of  more  recent  formation. 

The  peculiar  character  of  cell  cartilage  is  derived  from  the  presence 
of  a  substance  called  Chondrin,  which  resembles  much  ordinary  gela- 
tin, but  requires  a  longer  process  of  boiling  for  its  solution  in  water. 
Like  gelatin  it  solidifies  on  cooling,  and  when  the  moisture  is  com- 
pletely driven  from  it,  it  looks  like  hard  glue.  It  differs  from  gelatin 
in  not  being  precipitated  by  tannic  acid ;  a  difference  is  also  observed 
in  the  case  of  several  other  re-agents.  Thus,  for  example,  it  forms 
precipitates  with  acetic  acid,  alum,  acetate  of  lead,  and  protosulphate 
of  iron,  which  do  not  disturb  gelatin,  and  it  contains  upon  chemical 
analysis  less  nitrogen  and  more  hydrogen. 

The  nutrition  of  cartilage,  it  is  believed,  is  accomplished  through  the 
agency  of  the  cells,  or  cartilage  corpuscles.  The  cells  contiguous  to 
the  blood-vessels  of  the  region  eliminate  from  the  latter  the  requisite 
materials,  and  transmit  them  to  the  proximate  series  of  cells ;  the  latter 
do  the  same  in  their  order,  and  so  on  in  succession  until  the  whole  is 
nourished.  In  cases  where  from  inflammation  there  has  been  a  vascu- 
larity  in  articular  and  other  cell  cartilages,  these  vessels  are  formed  in 
a  new  tissue,  the  product  of  the  inflammatory  process. 

It  has  been  ascertained  that  all  the  cartilages  of*  a  foetus,  both  the 
ossific  and  the  permanent,  are  composed  of  chondrin,  but  so  soon  as 
ossification  commences,  the  chondrin  of  the  former  is  changed  into 
gelatin,  while  it  remains  constant  in  the  permanent  cartilages,  unless 
they  also  change;  this  has  led  to  the  conjecture  that,  as  chondrin  is 
nearer  alike  to  protein,  so  it  is  merely  an  intermediate  stage  for  the 
formation  of  gelatin. 

As  the  individual  reaches  adult  age,  the  cartilages  acquire  the 
strength,  whiteness,  and  great  elasticity  which  distinguish  them.  In 
old  age  they  become  yellowish,  more  brittle,  and  are,  as  said,  generally 
disposed  to  ossify.  Those  of  the  ribs  and  larynx  are  frequently  ossified 
at  forty  years  of  age.  The  ossification  of  those  of  the  movable  joints 

*     »  Gerber,  Gen.  Anat.  p.  171. 


THE  CARTILAGINOUS  SYSTEM.  257 

is  rare,  and  begins  at  a  more  advanced  period.     In  the  first  two  it 
begins  commonly  near  their  centre,  and  in  the  last  on  the  surface. 


SECT.    I. — PRETERNATURAL  DEVELOPMENT  OF  CARTILAGES. 

The  abnormal  development  of  cartilages,  in  the  tissues  and  organs 
of  the  body,  to  which  they  are  very  slightly  allied  in  their  nature,  is  a 
circumstance  by  no  means  uncommon,  and  is  met  with  annually,  in 
most  of  its  varieties,  in  our  dissecting-rooms.  As  there  is  a  great 
disposition  in  such  cartilages  to  ossify,  they  are  presented  in  the 
several  gradations  from  a  soft  gelatinous  body  to  that  of  perfect  bone. 
They  occur  in  the  articulations ;  in  the  lungs,  and  form  there  fistulous 
passages;  very  frequently  on  the  surface  of  the  spleen ;  in  the  pleura; 
in  the  fibrous  coat  of  the  large  arteries,  particularly  the  arch  of  the 
aorta;  and  in  the  semilunar  valves  of  the  same;  in  the  ovarium,  when 
it  becomes  dropsical ;  and  also  in  many  other  parts  of  the  body. 

The  cartilages  which  are  found  loose  in  the  joints  and  floating  about 
there,  begin,  for  the  most  part,  in  the  fibrous  structure1  exterior  to  the 
synovial  membrane ;  the  latter  is  protruded  inwards  by  them,  and 
gives  them  a  covering  resembling  the  finger  of  a  glove.  As  these 
bodies  are  small  and  rounded,  when  they  protrude  into  the  joint  the 
synovial  membrane  forms  a  pedicle  or  base  to  them,  which  is  finally 
ruptured,  and  then  the  cartilage  becomes  loose.  These  bodies  are 
generally  ossified  in  their  centre;  of  course  they  have  gone  through  the 
usual  progress  and  phenomena  of  ossification.  The  other  forms  of 
preternatural  cartilage  are  much  disposed  to  ossify  in  the  arteries,  but 
not  so  much  so  in  the  other  organs.  In  these  cases  they  are  laminated 
and  adhere  by  their  surfaces,  very  closely,  to  the  contiguous  structure, 
so  as  to  be  membranous.  M.  Laennec  has  seen  a  cartilaginous  trans- 
formation of  the  mucous  membrane  of  the  urethra ;  M.  Beclard  of  the 
mucous  membrane  in  the  vagina,  attended  with  prolapsus  uteri,  and 
also  of  the  prepuce  of  an  old  man,  who  had  a  phymosis  from  birth. 


SECT.  II. — OF  THE  PERICHONDRIUM. 

All  the  cartilages,  except  the  articular  ones,  are  invested  by  a  mem- 
brane called  perichondrium  (periehondre).  It  is  best  seen  on  the  larynx, 
and  on  the  cartilages  of  the  ribs.  Its  structure  is  fibrous,  and  corre- 
sponds so  fully  with  that  of  the  periosteum,  that  it  may  be  considered 
the  same  sort  of  membrane.  It  is,  however,  less  vascular  than  the 
periosteum,  and  adheres  to  the  cartilages  with  le^s  force,  owing  to  the 
fibrous  connection  between  them  being  not  so  abundant.  Bichat's  ex- 
periments prove  that  the  cartilage  is  much  less  affected  by  the  loss  of 
this  membrane  than  the  bone  is  by  that  of  the  periosteum:  its  uses 
are  no  doubt  the  same. 

!  Be.-lard,  Anat.  Gen. 
VOL.  I. — 17 


258  SKELETON. 


CHAPTER  II. 

LIGAMENTOUS  OR  DESMOID  TISSUE. 
Histology  of  the  Desmoid  Tissue. 

THE  Desmoid  Tissue  (Textus  Desmosus,  Systeme  Fibreux)  is  very 
generally  diffused  in  the  human  body,  has  a  very  close  connection  with 
the  cellular  texture,  and  is  continuous  with  it  in  divers  places.  It  may 
be  known  by  its  whiteness,  the  firmness  and  unyielding  nature  of  its 
materials,  and  its  fibrous  arrangement.  It  is  most  commonly  employed 
in  fastening  the  bones  to  each  other  at  their  articulations,  in  envelop- 
ing the  muscles,  in  connecting  the  latter  by  tendon  .to  the  skeleton, 
and  in  completing  them  ;  but  it  is  also  used  in  many  other  ways.  Its 
application  in  the  formation  of  the  joints  is  our  present  object;  but 
before  that  is  particularly  noted,  it  will  be  useful  to  enter  into  some 
general  considerations  in  regard  to  its  intimate  structure,  and  the  ob- 
servations now  made  can  be  applied  on  all  other  occasions  when  this 
tissue  is  in  question. 

A  desire  to  generalize,  and  consequently  to  simplify,  has  induced 
anatomists  to  seek  for  some  fountain  or  source  from  which  all  the  re- 
flections and  applications  of  the  desmoid  tissue  might  be  traced.  The 
Arabians  thought  that  the  dura  mater  was  this  source ;  and  the  error 
was  sanctioned  for  a  long  time  by  the  authority  of  Sylvius.  The  cele- 
brated Bichat,  in  observing  the  connections  of  this  tissue,  finding  that 
all  its  points  of  application  might  be  traced  either  mediately  or  directly 
to  the  periosteum,  considered  the  latter  as  its  centre ;  as  the  heart  is 
the  centre  of  the  circulation,  and  the  brain  of  nervous  energy;  not 
that  he  thought  the  periosteum  radiated  its  influence  on  all  its  depend- 
ent organs,  but  because  anatomical  inspection  demonstrated  all  the 
fibrous  organs  to  be  connected  with  it,  and  communicating  through  it 
with  each  other.  The  late  Professor  Bonn,  of  Amsterdam,  reversed 
the  idea  of  Bichat,  and  considered  the  aponeuroses  of  the  extremities, 
and  of  the  trunk,  which  send  their  partitions  between  the  muscles,  and 
down  to  the  periosteum  and  joints,  as  the  much  desired  centre  of  the 
desmoid  system.  The  latter  idea  has  been  reiterated  by  others,  and 
the  supposed  emanations  from  the  superficial  aponeuroses  diligently 
traced.  As  means  of  studying  the  position  and  connections  of  parts, 
notwithstanding  the  construction  is  a  very  forced  one,  which  makes 
desmoid  tissue  cellular  membrane,  and  cellular  membrane  desmoid  tis- 
sue, alternately,  so  as  to  suit  the  arrangement  of  the  anatomist,  instead 
of  that  of  nature ;  yet  any  or  all  of  these  plans  have  their  use,  and 
may  be  followed  advantageously,  after  the  study  at  large  of  the  human 
fabric. 

The  desmoid  tissue  is  essentially  fibrous,  but  without  a  uniform  ar- 
rangement, as  its  fibres  are  either  parallel,  crossed  or  mixed.  There 


LIGAMENTOUS  OR  DESMOID  TISSUE.  259 

are  two  species  of  desmoid  tissue ;  the  one  most  generally  diffused  is 
readily  known  by  its  whiteness  and  inextensibility.  The  other  by  its 
yellow  tinge  and  by  its  elasticity,  whence  it  is  called  the  yellow  elastic 
tissue. 

The  White  Desmoid  or  Fibrous  Tissue. — In  some  places  the  white 
fibres  are  very  compact,  and  separate  with  difficulty,  but  generally  pro- 
longed maceration  will  cause  them  to  part  into  filaments  as  fine  as  the 
thread  of  the  silkworm.  Anatomists  differ  in  regard  to  the  ultimate 
structure  of  these  fibres.  By  M.  Chaussier  'they  are  thought  to  be 
primitive  and  peculiar ;  Mascagni1  supposed  that  they  were  lymphatics, 
enclosed  in  a  vascular  web;  Isenflam,  that  they  were  cellular  substance 
imbued  with  gluten  and  albumen  ;  and  M.  Beclard,  observing  that 
maceration  resolves  them  into  a  species  of  mucous  or  cellular  substance, 
teaches  that  they  are  the  latter  in  a  condensed  state,  which  opinion  is 
corroborated  by  the  microscope.  Bichat's  opinion  was  that  the  tissue 
is  peculiar,  and  that  maceration  only  brings  into  view  the  cellular  sub- 
stance which  unites  its  fibres.  Though  maceration  and  chemical  man- 
agement evolve  striking  coincidences  with  cellular  membrane,  yet  in 
the  natural  and  ordinary  state  there  are  some  very  strong  points  of 
difference  from  it.  Among  these  may  be  remarked  its  great  want  of 
elasticity,  which  causes  it  to  tear  sooner  than  to  stretch,  and  in  general 
anasarca,  its  being  only  very  partially  affected,  merely  rendered  a  lit- 
tle more  moist  and  humid,  which  even  then  may  arise  from  the  small 
quantity  of  cellular  substance  in  it.  Many  parts  of  it,  however,  are 
unaffected  in  the  latter  way,  as  the  tendons  and  their  sheaths.  This 
tissue  naturally  contains  a  considerable  quantity  of  water,  which  it 
loses  by  exposure  to  the  air;  it  then  is  much  reduced  in  volume,  and 
becomes  hard  and  yellowish,  and  is  made  semi-transparent  by  being 
put  into  spirits  of  turpentine. 

The  white  fibrous  tissue,  according  to  the  microscope,  consists  of 
ultimate  transparent  undulating  filaments,  having  a  diameter  from  the 
^uio^h  to  tne  Tsiff^h  °f  an  inch.  The  fasciculi  into  which  they  are 
collected  measure  from  the  7 g^th  to  the  3^50^  °f  an  incn  broad,  and 
have  their  ultimate  filaments  held  together  by  an  amorphous  substance 
called  the  cytoblastema.  The  ultimate  fibres  appear  to  be  identical  in 
fibrous,  fibro-cellular,  and  cellular  tissue.  The  more  obvious  differences 
of  these  tissues  arise  from  the  mechanical  apposition  of  the  fibres, 
whether  they  are  parallel  or  interwoven,  or  a  combination  of  the  two. 
If  the  fasciculi  be  absolutely  straight,  but  a  very  small  elasticity  exists, 
amounting  to  almost  nothing,  as  in  the  case  of  tendons ;  but  in  some 
of  the  developments  of  this  tissue,  the  intertexture  of  their  filaments  and 
fasciculi  imparts  a  high  degree  of  elasticity.  Like  a  muslin  bandage, 
which  if  torn  out  straight  yields  but  little,  and  if  cut  bias  then  is  very 
elastic,  a  modification  of  property  highly  applicable  in  certain  surgical 
dressings. 

This  tissue  has,  in  many  cases,  its  fasciculi  observing  a  parallel  wavy 
course  in  their  fibres,  which  by  the  different  reflections  of  light,  pro- 
duces a  resemblance  to  a  watered  ribbon.  This  is  the  case  especially 
in  their  larger  fasciculi  and  in  tendons. 

1  Prodomo  della  Grande  Anatomia. 


260 


SKELETON. 


A  microscopical  view  of  the  white  Fibrous  Tissue,  magnified  320  diameters— 1,  2.  The  straight  ap- 
pearance of  the  tissue  when  stretched,  as  in  ligaments  of  the  funicular  and  fascicular  kinds.  3,  4,  5. 
Show  the  various  wavy  appearances  which  the  tissue  exhibits  when  not  stretched. 

The  white  desmoid  tissue,  by  being  subjected  to  the  heat  of  boiling 
water,  contracts,  becomes  more  solid,  and  is  elastic;  but  if  it  be  con- 
tinued there,  it  gradually  softens,  becomes  semi-transparent,  and  gela- 
tinous. The  mineral  acids  reduce  it  to  a  pulpy  state,  and,  if  concen- 
trated, will  dissolve  it  entirely.  Acetic  acid  makes  the  filaments  swell 
and  be  indistinct  as  in  cellular  tissue;  it  discloses  nuclei  and  also  the 
existence  of  the  yellow  elastic  tissue  in  some  amount.  The  alkalies 
loosen  its  texture,  cause  the  fibres  to  separate  easily,  and  to  assume  a 
diversity  of  colors.  It  putrefies  but  slowly,  in  this  respect  being  next 
to  the  cartilages. 

The  strength  of  this  texture  is  remarkable,  and  adapts  it  to  the  sus- 
taining of  enormous  weights;  a  faculty  which  is  continually  in  requisi- 
tion, both  to  retain  the  articular  surfaces  of  bones  in  contact,  and  the 
muscles  and  tendons  in  their  places.  It  is  well  known  that  the  patella, 
the  olecranon,  and  the  os  calcis  break  frequently  before  their  tendinous 
attachments  will  give  way.  In  the  history  of  punishments,  where 
criminals  have  been  fastened  to  four  horses,  it  is  said  that  it  has  been 
found  necessary  to  use  a  knife  to  assist  in  their  disarticulation.  All 
these  phenomena  occur  when  abrupt  violence  is  resorted  to,  so  little 
are  the  ligaments  disposed  to  yield ;  but  when  the  causes  of  distension 
act  slowly  and  gradually,  as  in  dropsies  of  the  joints,  the  fibres  sepa- 
rate, and  are  sometimes  completely  disunited.  When  the  distending 
cause  ceases  to  operate  in  the  latter  case,  the  ligaments  have  the  power 
of  contracting  in  the  same  gradual  way  and  of  restoring  themselves. 

Some  of  the  desmoid  tissues,  besides  having  their  fibres  surrounded 
and  their  interstices  occupied  by  cellular  substance,  contain  a  very 
small  quantity  of  oily  or  fatty  matter.  This  is  not  very  obvious  in 
their  recent  state;  but,  by  drying  them,  it  will  be  seen  in  small  quan- 
tities on  their  surface,  like  a  greasy  exudation ;  this  probably  comes 
from  the  fat  vesicles  deposited  in  their  cellular  substance.  They  are 


LIGAMENTOUS  OR  DESMOID  TISSUE.  261 

furnished  but  sparingly  with  blood-vessels,  which,  for  the  most  part, 
are  capillary.  The  periosteum  and  the  dura  mater  are,  however,  ex- 
ceptions to  this  rule.  Lymphatic  vessels  have  been  observed  in  some 
of  them,  but  it  is  doubtful  whether  they  generally  have  nerves.1 

S.  Pappenheim  has  asserted  that  in  his  dissections  he  has  been  able 
to  trace  nervous  filaments  in  the  periosteum,  in  ordinary  ligaments,  in 
capsular  ligaments;  and  sometimes  in  the  tendons,  but  not  those  of  the 
human  subject;  that  they  invariably  attend  the  blood-vessels  of  these 
parts  respectively  and  end  in  terminal  loops.8 

The  sensibility  of  this  tissue  is  extremely  obscure,  and  is  not  mani- 
fested under  the  usual  mechanical  and  chemical  irritants;  it  may,  how- 
ever, be  elicited  by  communicating  to  the  joints  a  twisting  motion,  as 
the  experiments  of  Bichat  prove.  Inflammation  augments  their  sen- 
sibility, in  which  case  it  becomes  extremely  acute ;  as  in  gout  and 
rheumatism,  or  any  other  cause  productive  of  it. 

The  Yellow  or  Elastic  Desmoid  Tissue  is  far  from  being  in  the  same 
abundance  with  the  other.  One  of  the  best  instances  of  it  exists  in 
the  case  of  the  ligaments  between  the  bony  bridges  of  the  vertebrae  ; 
but  it  is  found  in  the  middle  coat  of  the  blood-vessels,  in  the  skin,  in 
the  trachea,  in  the  ligaments  of  the  larynx,  the  stylo-hyoid,  in  the 
fasciae,  and  in  some  other  parts.  A  very  remarkable  example  of  it  is 
seen  in  the  ligamentum  nuchae  of  the  larger  quadrupeds,  where  it  is 
introduced  as  an  adjuvant  to  the  muscles  in  keeping  the  head  adjusted. 

Fig.  71. 


The  yellow  Fibrous  Tissue,  showing  the  curly  and  branched  disposition  of  its  fibrillfB,  their  definite 
outline  and  abrupt  mode  of  fracture,  magnified  320  diameters.— 1.  The  structure  undisturbed,  and  not 
moved  from  its  natural  position,  as  seen  in  the  rest  of  the  specimen. 

Its  chief  characteristic  is  its  elasticity,  which  it  has  to  a  very  high 
degree;  but  in  strength  it  is  inferior  to  the  white  fibrous  tissue,  and  it 
breaks  across  the  course  of  its  fibres.  The  fibres  part  without  much 
difficulty  from  one  another.  As  they  run  side  by  side,  they  observe  a 
bending  course,  with  curves  wider  than  the  white.  They  divide  into 

1  Beclard,  Anat.  Gen.  2  Mailer's  Arch.  1843. 


262  SKELETON. 

branches  at  some  points,  and  in  others  join  with  contiguous  fibres  so 
as  to  anastomose  in  a  reticular  connection.  When  the  fibre  is  broken  its 
end  curls  up.  Their  size  varies  from  the  24^(jth  to  the  ? J^ ^th  of  an 
inch.  In  the  ligamenta  subflava  of  the  spine,  their  general  diame- 
ter is  about  7  s^th  of  an  inch.  Their  outline  is  remarkably  distinct. 
Being  to  some  extent  generally  blended  with  the  white  desmoid,  or 
cellular  tissue,  they  are  rendered  more  manifest  by  touching  them  with 
acetic  acid,  which  softens  and  partially  dissolves  the  other  without  in- 
fluencing them. 

Their  blood-vessels  are  but  few  in  number,  and  it  is  not  yet  ascer- 
tained that  they  have  lymphatics  and  nerves. 

The  elastic  tissue  does  not  contain  quite  so  much  water  as  the  white. 
One-half  is  reduced  by  long  boiling  to  gelatin;  the  other  remains 
undissolved. 


CHAPTER  III. 

HISTOLOGY  OF  THE  FIBRO  OR  LIGAMENTO-CARTILAGINOUS 

SYSTEM. 

THIS  set  of  organs  (Systdme  fibro-cartilagineux)  has  been  placed  by 
anatomists  indiscriminately  in  the  cartilaginous  or  in  the  ligamentous 
system,  in  consequence  of  its  participating  in  the  characters  of  both; 
it,  however,  from  its  importance,  should  have  a  distinct  position. 
There  are  three  varieties  of  this  system.  The  first  presents  itself  in  a 
membranous  state,  and  is  represented  by  the  external  ear,  by  the  alse 
of  the  nose,  by  the  cartilages  of  the  eyelids,  and  by  the  trachea. 
The  second  is  represented  by  the  inter-articular  cartilages  of  the  mova- 
ble articulations,  as  of  the  knee,  the  wrist,  lower  jaw,  and  also  by  the 
inter-vertebral  matter  which  holds  the  bodies  of  the  vertebrae  together. 
The  third  is  represented  by  the  trochlese  and  sheaths,  formed  on 
the  surface  of  bones  for  the  sliding  of  tendons.  These  varieties  differ 
much  one  from  the  other  in  the  relative  proportion  of  their  constituents, 
and  in  the  position  of  the  same. 

The  principal  constituent  of  this  system  is  a  strong  fibrous  matter, 
which  is  intermixed  with  the  cartilage,  and  has  in  some  places  its  sur- 
face covered  by  the  latter.  The  fibres  even  by  superficial  observation 
may  be  traced  in  various  directions:  in  some  places  they  are  parallel; 
in  others  intermixed  and  crossed  very  much ;  in  others  concentric. 
Their  strength  is  of  the  first  degree.  The  cartilaginous  part  fills  up 
the  intervals  between  the  fibres,  and  gives  to  the  whole  structure  its 
whiteness  and  elasticity. 

The  fibro-cartilages  may  be  converted  by  the  action  of  hot  water 
into  gelatin,  but  the  process  is  slower  than  in  the  simple  cartilage. 
The  membranous,  or  first  variety,  differs,  however,  from  the  other  two 


ARTICULAR  CARTILAGES.  263 

in  this  respect  *  for,  if  it  can  be  reduced  at  all  into  gelatin,  the  quan- 
tity it  yields  is  not  perceptible.  The  fibro-cartilages  contain  few  or 
no  cartilage  corpuscles  or  cells,  and,  according  to  Miiller,  do  not  yield 
chondrin  upon  being  boiled. 

This  system  is  destitute  of  perichondrium,  with  the  exception  of  the 
first  variety,  in  which  it  is  distinguishable ;  but  the  others  either  ad- 
here to  the  bone,  or  are  covered  by  a  synovial  reflection;  their  margins 
holding  in  such  cases  to  the  contiguous  ligamentous  structure. 

There  is  a  very  small  quantity  of  cellular  tissue  in  this  system. 
Artificial  injection  manifests  but  few  blood-vessels  in  it;  if  the  animal, 
however,  be  strangled  for  the  purpose,  the  blood  by  accumulating  in 
the  capillaries  becomes  sufficiently  apparent. 


CHAPTER  IV. 


SECT.  I. — OF  THE  MECHANISM  OF  THE  JOINTS. 

The  Ligaments  (Ligamenta),  properly  speaking,  are  those  organs 
which  tie  the  bones  together,  and  are  mostly  of  the  white  fibrous  tissue. 
In  the  movable  joints  they  are  either  Capsular  (capsules  fibreux)  or 
Funicular  (ligamens  fibreux  fasciculaires}.  The  first  are  like  a  bag 
open  at  the  ends,  at  either  of  which  the  articular  extremity  of  a  bone 
is  included.  These  are  much  more  complete  in  some  joints  than  in 
others;  the  shoulder  and  the  hip  joints  afford  the  most  perfect  ex- 
amples; in  other  joints  they  are  divided  into  irregular  fasciculi  of 
fibres,  permitting  the  synovial  membrane  to  appear  in  their  interstices, 
and  sometimes  they  are  still  more  widely  separated. 

The  funicular  ligaments  are  mere  cords,  extending  from  one  bone  to 
another;  some  of  them  are  flattened,  some  rounded,  and  others  oval 
or  cylindroid.  They  are  variously  placed;  in  some  instances  they  are 
surrounded  by  the  capsular  ligament,  and  in  others,  on  its  outer  sur- 
face, and  sometimes  are  so  blended  with  it  as  not  to  be  separated  with- 
out an  artificial  disunion.  Their  names  are  derived  either  from  their 
position  or  shape,  and  are  generally  sufficiently  appropriate. 


SECT.  II. — OF  THE  ARTICULAR  CARTILAGES. 

To  this  class  we  refer,  exclusively,  such  as  adhere  by  one  surface  to 
the  articular  facings  of  the  bones,  and  present  the  other  surface  to  the 
cavity  of  the  joint.  Every  movable,  and  some  of  the  immovable  ar- 
ticulations, have  their  surface  uniformly  thus  incrusted  to  a  thickness 
varying  from  the  fraction  of  a  line  in  the  smallest  joints,  to  one  line  in 
the  largest.  The  cartilage  itself  is  rather  thinner  near  the  margin  of 


264  SKELETON. 

the  articular  surface,  when  the  latter  is  convex,  than  it  is  near  the 
centre;  on  the  contrary,  when  the  surface  is  concave,  the  cartilage  is 
thickest  near  its  periphery. 

These  cartilages,  when  subjected  to  a  maceration  of  six  months,  are 
stripped  of  the  reflection  of  synovial  membrane,  which  covers  their 
articular  surfaces,  and  are  resolved  into  fibres,  one  end  of  which  ad- 
heres to  the  bone  and  the  other  end  points  to  the  joint.  If  the  pre- 
paration be  then  dried,  the  distinction  of  fibres  becomes  more  mani- 
fest. 

This  filamentous  appearance  has  been  considered  to  depend  upon 
the  columnar  arrangement  of  the  cartilage  cells,  but,  according  to  Dr. 
Leidy,1  it  is  caused  by  the  existence  of  intercellular  filaments  with  a 
transverse  measurement  of  only  the  3I  J^th  of  an  inch.  The  smooth- 
Fig.  72. 


Represents  a  shred  of  Articular1  Cartilage,  with  a  row  of  three  cartilage-cells,  torn  from  a  broken 
edge  of  the  articular  cartilage  of  the  condyles  of  the  os  femoris,  highly  magnified,  exhibiting  the  fila- 
mentary structure. 

ness  of  the  free  surface  of  the  articular  cartilage,  considered  by  some 
to  be  an  extension  of  the  synovial  membrane,  and  by  others  to  be  the 
result  of  a  transverse  course  of  the  cartilage  cells,  he  concludes  is 
produced  by  similar  delicate  filaments,  forming  a  layer  intermixed  with 
cartilage  corpuscles  and  parallel  to  the  surface  of  the  bone,  a  sort  of 
capping,  as  it  were,  to  the  vertical  filaments.  He  has  also  detected 
small  lacunae,  near  the  attached  surface  of  the  articular  cartilages  and 
placed  transversely,  with  filaments  of  bone  laid  in  the  same  direction. 
The  most  successful  injections,  closely  examined  with  a  microscope, 
demonstrate  the  defect  of  blood-vessels  in  them.  The  vessels  are  uni- 
formly seen  to  terminate  at  the  circumference  of  the  cartilage  and  at 
the  face  which  adheres  to  the  bone,  but  never  to  penetrate  it.  Their 
organization  is,  therefore,  extremely  simple,  and  such  as  subjects  them 
to  but  few  morbid  alterations.  When  partially  removed  from  the  bone, 

1  Am.  Journ.Med.  Sciences,  No.  2,  Philad.  1849. 


SYNOVIAL  ARTICULAR  CAPSULES.  265 

the  latter  occasionally  reproduces  them,  hut  the  edges  of  the  new  and 
of  the  old  production  do  not  unite.  I  have,  in  cases  of  inflammation 
of  the  joints,  seen  the  fibres  of  these  cartilages  much  longer  than 
usual,  and  detached  from  each  other.  When  a  joint  is  laid  open  by  a 
wound,  and  suppurates,  the  cartilage  softens  and  disappears  from  the 
circumference  to  the  centre.1 


SECT.  III.  —  OF  THE  SYNOVIAL  ARTICULAR  CAPSULES. 

Each  movable  articulation  is  lined  by  a  membrane  (membrana  syno- 
vialis],  reflected  over  the  internal  face  of  the  capsular  ligament  and 
apparently  over  the  whole  free  surface  of  the  articular  cartilages. 
This  membrane  is  a  perfect  sac  ;  and,  unlike  the  capsular  ligament,  has 
no  opening  in  it.  It  is  remarkably  distinct  where  it  is  not  attached  to 
the  articular  cartilages,  and,  by  being  inflated,  is  caused  to  protrude 
in  small  vesicles,  or  pouches,  between  the  fasciculi  of  the  ligamentous 
structure.  Its  connection  with  the  cartilage,  and  its  continuation  over 
it,  are  not  quite  so  obvious,  and  require  more  management  to  demon- 
strate: it  is,  indeed,  so  thin  and  transparent  at  this  part,  and  adheres 
so  closely,  that  its  existence  there  is  questioned.  The  proofs  to  the 
naked  eye  are,  that  by  maceration  it  becomes  so  loose,  that,  with  a  pair 
of  forceps,  shreds  of  it  may  be  raised  along  the  whole  extent  of  the 
cartilage.  If  a  flap  of  cartilage  be  raised  up  by  a  knife,  its  base  being 
left  attached,  in  attempting  to  tear  away  the  base,  it  will  be  found  that 
a  membrane  is  continued  from  this  base  to  the  contiguous  cartilage. 
Saw  a  bone  through  to  its  articular  cartilage,  then  tear  through  the 
cartilage  gently,  in  which  case  the  continuity  of  membrane  will  also 
be  manifested. 

From  these  several  proofs  the  fact  was  considered  as  established,  that 
the  synovial  membranes  are  bags,  closed  at  both  extremities,  and  differ 
therein  from  the  capsular  ligaments.  It  would  appear,  however,  that 
this  apparent  extension  of  the  synovial  membrane  over  the  entire  free 
surface  of  articular  cartilage  may  be  accounted  for  by  the  fine  fila- 
mentous structure  intermixed  with  cartilage  cells,  which  makes  the  cap- 
ping or  surface  to  the  articular  cartilage,  as  described  by  Dr.  Leidy. 
The  actual  influence  of  this  arrangement,  at  least,  is  to  furnish  a  modi- 
fied membrane  in  connection  with  the  regular  synovial,  but  destitute  of 
its  vascularity. 

In  the  foetus,  the  synovial  membrane  may  be  traced  over  the  whole 
surface  of  the  cartilage.8 

The  synovial  sacs  are  very  vascular  except  upon  the  articular  car- 
tilages, where  the  vascularity  is  no  longer  apparent,  or  advances  but  a 
very  short  distance.  M.  Beclard  says,  that  protracted  inflammation 
will,  finally,  redden  the  cartilaginous  portion,  and  that  it  extends  from. 

1  Bichat,  Anat.  Gen.     The  same  author  speaks  of  the  idiopathic  ulceration  of  cartilage,  as 
a  result  of  it^  inflammation.     The  late  Dr.  Physick,  whose  experience  was  equal,  deniod 
both. 

2  Quain  and  Sharper,  vol.  i.  p.  245. 


266  SKELETON. 

the  circumference  to  the  centre,  the  hues  being  lighter  the  nearer  it  is 
to  the  latter.  It  has  not  occurred  to  me  to  meet  with  this  proof;  though 
I  have  made  frequent  dissections  of  inflamed  joints  on  subjects,  the 
redness  has  always  ceased  at  the  margin  of  the  articular  cartilage. 
The  late  Professor  Physick's  experience,  most  valuable  on  all  occasions, 
affords  support  to  my  own.  Some  years  ago  I  had  an  opportunity  of 
investigating,  somewhat  fully,  this  point,  in  a  subject,  all  of  whose  large 
joints  were  in  a  state  of  inflammation. 

The  following  magnified  plate  of  the  head  of  the  os  femoris,  at  from 
the  third  to  the  fourth  month  of  fcetal  life,  will  represent  the  very  par- 
tial advance  of  vascularity  between  the  synovial  membrane  and  the 
articular  cartilage. 

Fig.  73. 


a.  The  surface  of  the  articular  cartilage,  near  the  ligamentum  teres.  b.  The  vessels  between  the 
said  cartilage  and  the  synovial  membrane,  c.  The  surface  where  the  ligamentum  teres  was  attached. 
d.  The  vein.  e.  The  artery. 

These  synovial  capsules,  or  membranes,  are  white,  thin,  semi-trans- 
parent, and  soft.  Wherever  there  is  a  deficiency  of  capsular  ligament, 
they  adhere  to  the  contiguous  cellular  substance,  and  are  so  blended 
with  it  as  to  appear  absolutely  continuous.  Dissection,  inflation,  and 
maceration,  prove  them  to  be  laminated,  and  develop  their  structure 
in  such  a  way  that  it  resolves  itself  into  a  cellular  tissue,  the  more 
interior  layers  of  which  had  been  in  a  very  compact  state.  In  all  this 
they  resemble  the  serous  membranes,  generally,  and  are  ranked  among 
them;  Bichat,  therefore,  considers  them  only  as  an  interlacement  of 
absorbents,  and  of  exhalants.  But,  for  the  farther  exposition  of  this 
point,  see  the  article  on  the  Serous  Membranes. 

The  synovial  sacs  have  on  their  outer  surface,  but  projecting  into  the 
cavity  of  the  joint,  adipose  cushions  of  different  sizes,  called  the  Syno- 
vial Glands  of  Havers,  from  which  it  was  long  supposed  that  the 
lubricating  liquor  of  the  joints  was  exclusively  secreted.  These  cushions 
have  their  projecting  margins  fringed  and  unusually  vascular,  and 
occupy  the  small  spaces  left  between  the  articular  faces  of  the  bones. 
As  they  are  covered  by  the  synovial  membrane  and  an  epithelium,  they 
no  doubt  assist  in  the  secretion  of  the  synovia.  The  original  view  of 
Havers  has  been  reproduced  lately  by  Mr.  Rainey  and  Mr.  Kolliker, 
with  some  additional  details  of  structure  in  regard  to  the  vessels  and 
the  fringed  edges.  The  bursae  mucosse  found  with  tendons,  and  else- 


ARTICULATION  OF  THE  LOWER  JAW.  267 

where,  as  beneath  the  skin,  and  where  surfaces  of  any  kind  rub  upon 
one  another,  are  similar  to  those  of  the  joints. 

The  movable  articulations  are  all  furnished  with  the  fluid  called 
Synovia  ;  this  name  was  given  to  it  by  Paracelsus,  from  its  resemblance 
to  the  albuminous  part  of  an  egg,  to  the  consistence  and  color  of  which 
it  has  a  close  affinity,  and,  like  it,  is  thick,  ropy,  and  somewhat  yellow- 
ish. The  chemical  analysis  of  it  indicates  the  presence  of  water, 
albumen,  and  a  kind  of  incoagulable  mucus.  It  was  once  supposed  to 
be  a  mixture  of  serum  with  the  adipose  matter  of  the  bones,  which 
found  its  way  into  the  joints  by  transudation ;  but  as  it  contains  upon 
experiment  no  oil,  the  opinion  is  evidently  erroneous.  It  is  secreted 
from  the  whole  internal  surface  of  the  synovial  membrane,  and,  per- 
haps, in  greater  quantities  from  the  fringed  fatty  cushions  in  the  joints 
in  consequence  of  their  increased  vascularity.  M.  Be'clard  teaches 
that  it  is  neither  a  follicular  nor  a  glandular  secretion,  nor  a  transuda- 
tion, but  a  perspiration,  in  which  a  perfect  equilibrium  is  kept  up 
between  its  exhalation  and  its  absorption.  Its  use  is  to  diminish  fric- 
tion, and,  consequently,  to  facilitate  the  sliding  of  the  bones  upon  each 
other. 

The  synovial  capsules  are  liable  to  a  fungous  degeneration,  which 
occurs  equally  upon  the  cartilaginous  and  capsular  portions  of  them. 
Factitious  bridles  sometimes  form  in  the  joints,  attached  indiscrimi- 
nately to  either  portion  of  the  synovial  membrane. 


CHAPTER  V. 
OF  THE  INDIVIDUAL  ARTICULATIONS. 

THE  mechanism  of  all  the  movable  articulations  consists  in  a  car- 
tilage covering  the  articular  surface  of  the  bone  ;  in  ligamentous 
bands,  either  of  a  filamentous,  funicular,  or  capsular  condition;  of  a 
synovial  membrane,  and,  as  the  case  maybe,  of  certain  accessories,  as 
inter-articular  cartilages  and  so  on.  Where  motion  is  not  intended, 
various  modifications  of  these  elements  of  structure  are  observed.  The 
several  specifications  will  be  given  in  the  following  account. 

ARTICULATION  OF  THE  LOWER  JAW. 

The  articular  connection  here  is  formed  by  that  portion  of  the  glenoid 
cavity  anterior  to  the  fissure  and  by  the  condyle  of  the  lower  jaw. 
Each  surface  is  covered  by  thin  cartilage,  and  a  thin,  loose,  irregular, 
fibrous,  capsular  ligament  arises  from  the  articular  margin  of  one  bone, 
to  be  inserted  into  that  of  the  other.  Besides  this,  there  are  four 


268  SKELETON. 

other  ligaments  for  strengthening  the  joint,  an  inter-articular  cartilage 
and  two  synovial  membranes. 

The  External  Lateral  Ligament  (Membrana  Articularis  Ligamentosa) 
arises  from  the  inferior  margin  of  the  root  of  the  jugal  or  zygomatic 
process  of  the  temporal  bone,  and  from  the  anterior  side  of  the  meatus 
externus,  and  is  inserted  into  the  neck  of  the  condyle.  It  is  somewhat 
triangular,  having  the  base  upwards,  and  is  identified  with  the  capsular 
ligament.  Just  in  advance  of  this,  and  separated  from  it  by  a  small 
fissure,  is  another  triangular  ligament,  the  discovery  of  which  is 
claimed  by  Caldani.1  It  arises  from  the  anterior  part  of  the  inferior 
margin  of  the  zygomatic  process  of  the  temporal  bone,  and  is  inserted 
into  the  neck  of  the  bone  in  advance  of  the  other. 

Fig.  74.  Fig.  75. 


Fig.  74.  An  external  view  of  the  articulation  of  the  Lower  Jaw.  1.  The  zygomatic  arch.  2.  The 
tubercle  of  the  zygoma.  3.  The  ramus  of  the  lower  jaw.  4.  The  mastoid  process  of  the  temporal 
bone.  5.  The  external  lateral  ligament.  6.  The  stylo-maxillary  ligament. 

Fig.  75.  An  internal  view  of  the  articulation  of  the  Lower  Jaw.  1.  A  section  through  the  petrous 
portion  of  the  temporal  bone  and  spinous  process  of  the  sphenoid.  2.  An  internal  view  of  the  ramus, 
and  part  of  the  body  of  the  lower  jaw.  3.  The  internal  portion  of  the  capsular  ligament.  4.  The 
internal  lateral  ligament.  5.  The  small  interval  at  its  insertion,  through  which  the  mylo-hyoideus 
nerve  passes.  6.  The  stylo-maxillary  ligament,  a  process  of  the  deep  cervical  fascia. 

The  Internal  Lateral  Ligament  (Lig.  Maxillde  Later  ale  Intern.)  or 
Spino-maxillary,  arises  from  the  extremity  of  the  spinous  process  of 
the  sphenoid  bone,  and  from  the  adjoining  part  of  the  petrous  portion 
of  the  temporal  bone,  and  going  downwards  and  outwards  is  inserted 
into  the  spine  bordering  the  posterior  mental  foramen,  and  for  some 
distance  lower  down  on  the  ramus  of  the  jaw.  It  is  placed  between 
the  two  pterygoid  muscles,  and  is  in  contact  with  the  inferior  max- 
illary vessels  and  nerve  as  they  run  between  this  ligament  and  the 
condyle  to  the  posterior  mental  foramen.  It  is  thought  by  Caldani 
to  be  not  so  useful  in  restricting  the  motion  of  the  jaw  forwards  as  in 
holding  the  vessels  and  nerves,  and  regulating  their  position,  lest  in 
the  various  motions  of  the  lower  jaw  they  should  be  displaced  and 
injured. 

The  Stylo-maxillary  Ligament  is  thinner  than  the  above.  It  arises 
from  the  external  side  of  the  styloid  process,  and  is  inserted  into  the 
posterior  margin  of  the  jaw,  near  its  angle,  between  the  masseter  and 
internal  pterygoid  muscles.  The  stylo-glossus  muscle  is  much  con- 

1  Tabul.  Anat.     Venetiis,  1802. 


ARTICULATION  OF  THE  LOWER  JAW.  269 

nected  with  it,  and  is  thereby  assisted  in  elevating  the  base  of  the 
tongue.     The  fascia  profunda  of  the  neck  is  in  continuation  with  it. 

Of  the  two  synovial  membranes,  one  is  reflected  between  the  glenoid 
cavity  and  the  upper  surface  of  the  inter-articular  cartilage ;  and  the 
other  between  this  latter  body  and  the  condyle  of  the  lower  jaw. 
They  may  be  seen  at  different  points  protruding  between  the  fibres  of 
the  capsular  ligament. 

The  Inter-articular  cartilage,  by  being  placed  between  the  two 
synovial  membranes,  separates  completely  the  two  bones.  Above,  its 
surface  corresponds  to  the  convexity  of  the  tubercle  of  the  temporal 
bone,  and  to  the  glenoid  cavity ;  below,  it  is  simply  concave  for  re- 
ceiving the  condyle.  It  is  thicker  at  the  circumference  than  in  its 
middle,  and  at  the  posterior  than  the  anterior  margin.  A  longitudinal 
section  of  it  from  before  backwards  and  near  its  middle  resembles 
the  letter  S.  Sometimes  it  is  open  in  the  centre,  in  which  case  the 
two  synovial  cavities  run  into  one  another.  Its  structure  is  fibro-carti- 
laginous.  It  moves  very  readily  backwards  and  forwards. 

On  the  posterior  face  of  the  capsular  ligament,  I  have  found,  in 
several  cases  (indeed,  on  all  occasions  of  special  examination  for  it, 
since  the  first  observation),  an  erectile  tissue  or  structure  resembling  the 
corpus  cavernosum  penis.  It  has  not  been  filled  with  blood  like  the 
latter,  but  is,  probably,  an  arrangement  for  giving  great  mobility  for- 
wards to  the  lower  jaw. 

The  movements  of  this  bone  may  be  simply  hinge-like,  by  its  de- 
pression, in  which  the  mouth  is  regularly  opened ;  or,  by  the  action  of 
the  pterygoid  muscles,  it  may  be  slid  forwards.  When  the  muscles  of 
but  one  side  act,  a  species  of  rotation  is  communicated ;  in  which  one 
condyle  advances  on  the  tubercle  of  the  temporal  bone,  while  the  other 
reaches  to  the  back  part  of  the  glenoid  cavity.  The  looseness  and 
length  of  the  capsular  ligament  of  the  articulation,  along  with  the 
extreme  facility  of  motion  from  the  interposition  of  a  movable  carti- 
lage, contribute  very  materially  to  this  movement.  The  sliding  back- 
wards and  forwards  of  the  intermediate  cartilage  of  this  articulation, 
during  mastication,  sometimes  produces  a  crackling  audible  to  the  by- 
standers, and  extremely  annoying  to  the  individual  who  is  the  subject  of 
it,  from  the  noise  being  so  near  his  ear. 

Some  persons  are  liable  to  a  spontaneous  dislocation  of  this  bone, 
from  yawning  too  widely.  I  am  disposed  to  believe  that,  in  such  cases, 
the  accident  arises  from  the  posterior  boundary  of  the  glenoid  cavity 
(as  established  by  that  margin  of  the  temporal  bone  which  is  continuous 
with  the  vaginal  process,  and  forms  a  part  of  the  meatus  externus), 
being  more  advanced  and  higher  than  usual ;  in  consequence  of  which, 
whenever  the  bone  is  depressed  to  a  certain  point,  its  neck  strikes 
against  this  ridge,  and  not  being  able  to  go  farther  back,  the  ridge  acts 
as  a  fulcrum,  and  starts  the  condyle  over  the  tubercle  of  the  temporal 
bone  into  the  zygomatic  fossa.  The  fact  is  certain,  that  very  strongly 
marked  differences  of  the  glenoid  cavity,  in  this  particular,  occur  in 
different  individuals. 


270  SKELETON. 


CHAPTER  VI. 

OF  THE  LIGAMENTS  OF  THE  SPINE. 
Ligaments  of  the  Bodies  of  the  Vertebrae. 

1.  Inter-vertebral  Substance  (Lig  amenta  Intervertelralia,  Ligamens 
Intervertebraux}. — The  bodies  of  the  true  vertebrae  are  united  by  plates 
of  a  substance  blending  the  nature  of  ligament  and  that  of  cartilage, 
and  therefore  called  fibro  or  ligamento-cartilaginous  matter.  It  oc- 
cupies all  the  space  between  the  contiguous  bodies  of  the  vertebrae, 
and  adheres  most  closely  to  their  substance.  The  plates  of  this  inter- 
vertebral  matter  increase  successively  in  thickness,  as  they  are  placed 
lower  down  on  the  spine,  whereby  the  lumbar  vertebrae  are  separated  at 
a  much  greater  distance  than  any  others.  The  curvatures  of  the  spine, 
as  formerly  stated,  depend  largely  upon  the  arrangement  of  this  sub- 
stance :  between  the  vertebrae  of  the  neck  the  plates  are  thicker  at  the 
anterior  margin  than  at  the  posterior ;  on  the  contrary,  between  the 
dorsal  vertebrae  they  are  thinner  in  front.  In  the  loins,  the  plate  is  again 
much  thicker  in  front  than  behind,  and  this  feature  is  especially  marked 
between  the  last  lumbar  vertebra  and  the  sacrum. 

This  inter-vertebral  matter  is  formed  principally  of  concentric 
lamellae,  the  texture  of  which  is  ligamentous.  These  lamellae  are  more 
abundant  anteriorly  and  laterally  than  behind.  Their  fibres  cross  in 

Fig.  76. 


Lnmbar  Vertebrae  with  the  intervertebral  substance  are  seen  from  before.  By  removing  apor- 
one  layer  of  the  latter,  another  layer  is  partly  exposed,  and  the  difference  in  the  direction  of 


Two  Lnmbar  Ve 
tion  of 
their  fibres  is  made  manifest. 


every  direction,  leaving  between  them  intervals  filled  with  a  soft,  pulpy 
substance,  which  is  cartilaginous :  the  cartilage  is  defective  near  the 
circumference,  but  in  approaching  the  centre,  it  becomes  more  and 
more  abundant,  as  the  interstices  are  larger,  until  the  centre  seems  to 
be  constituted  almost  entirely  by  it  in  a  very  soft  state.  The  pulpy, 
or  cartilaginous  mass  in  the  centre,  is  in  a  state  of  considerable  com- 
pression, which  may  be  proved  by  separating  the  bodies  of  adjoining 


LIGAMENTS  OF  THE  SPINE.  §71 

vertebrae,  or  by  making  a  vertical  section  through  them ;  in  which  case 
the  pulp  will  be  freed  from  compression,  and  will  rise  up  into  the  form 
of  a  flat  cone.  This  experiment  will  succeed  remarkably  well  in  the 

Fig.  77.  Fig.  78. 


Fig.  77.  A  Lumbar  Vertebra,  with  a  horizontal  section  of  intervertebral  substance  above  it.  ,At  the 
circumference  the  concentric  arrangement  of  the  layers  of  the  latter  is  shown,  and  in  the  middle  the 
pulpy  substance  is  indicated. 

Fig.  78.  Alvertical  section  of  two  Vertebrae,  and  the  substance  interposed  between  their  bodies.  The 
direction  of  the  layers  of  the  intervertebral  substance  is  displayed.  1.  Layers  curved  outwards. 
2.  Those  curved  inwards.  3.  Pulpy  substance  in  the  middle. 

loins ;  from  which  it  is  evident  that  this  mass  is  a  soft  and  elastic  ball, 
on  which  the  bodies  of  the  vertebrae  play. 

If  the  outer  circumference  of  the  inter-vertebral  plate  be  cut  through 
in  the  plane  of  its  attachment  to  the  vertebra,  and  the  joint  then  forced 
open,  it  will  be  found  that  the  strongest  adhesion  had  been  at  the  cir- 
cumference, for  the  surfaces  within  part  with  comparative  ease,  and  a 
thin  scale  or  plate  of  cartilage  will  be  found  adhering  to  the  face  of  the 
vertebra,  and  concealing  it.  This  plate  is,  probably,  the  last  vestige 
of  the  epiphysis  of  the  vertebra. 

The  pulp  is  proportionably  much  more  abundant  in  infancy  than  in 
the  subsequent  periods  of  life  ;  it  is  also  much  softer,  whiter,  and  more 
transparent.  In  advanced  life  there  is  great  diminution  of  its  volume, 
as  well  as  of  its  elasticity,  which  accounts,  in  some  measure,  for  the 
comparative  stiffness  of  the  spine  in  old  people.  The  fibrous  part  in 
them  is  always  more  abundant,  and  is  disposed  to  ossify.  When  the 
trunk  is  kept  erect  for  several  hours  in  succession,  it  becomes  shorter, 
from  its  weight  bearing  upon  the  inter-vertebral  matter ;  but  a  short 
period  of  rest  in  the  horizontal  position  restores  the  spine  to  its 
original  length. 

2.  Anterior  Vertebral  Ligament  (Fascia  Longitudinalis  Anterior, 
Ligament  Vertebral  Anterieur). — This  ligament  is  placed  on  the  front 
part  of  the  spine,  and  extends  from  the  second  vertebra  of  the  neck  to 
the  first  bone  of  the  sacrum,  inclusively.  It  increases  gradually  in 
breadth,  from  its  commencement  to  its  termination,  but  is  not  every- 
where of  the  same  thickness ;  for  it  is  thin  on  the  neck,  thicker  in  the 
thorax,  and  again  becomes  thin  in  the  loins  :  in  the  latter,  however,  it 
is  strengthened  by  an  accession  of  fibres  from  the  tendinous  crura  of 
the  diaphragm.  It  might  be  very  properly  considered  as  beginning  at 
the  cuneiform  process  of  the  occipital  bone,  as  there  is  a  fasciculus  to 


272  SKELETON. 

Fig.  79. 


An  anterior  view  of  the  ligaments  of  the  Vertebrae  and  Ribs.— 1.  The  anterior  vertebral  ligament. 
2.  The  anterior  costo-yertebral  ligament.  3.  The  internal  transverse  ligament.  4.  The  inter-arti- 
cular ligament,  connecting  the  head  of  the  rib  UTthe  inter- vertebral  substance. 

represent  it,  going  down  to  the  second  cervical  vertebra,  but  inter- 
rupted there,  immediately  after  which  it  is  resumed. 

This  ligament  adheres  very  closely  to  the  inter-vertebral  substances, 
or  plates,  and  to  the  projecting  margins  of  the  bodies  of  the  vertebrse, 
but  less  closely  to  the  middle  or  concave  parts  of  the  latter.  Its  fibres 
do  not  run  out  its  whole  length,  for  the  more  superficial  extend  from 
one  vertebra  or  inter- vertebral  substance  to  the  fourth  or  fifth  below ; 
the  middle  ones  extend  to  the  second  or  third  below,  and  the  deepest 
seated  are  applied  between  the  proximate  vertebrse  only.  In  general, 
more  of  the  fibres  are  inserted  into,  and  arise  from  the  fibro-cartilagi- 
nous  matter,  than  in  the  case  of  the  bones.  .  In  several  parts,  but  par- 
ticularly in  the  neck,  small  slips  are  sent  off  obliquely  to  the  vertebra 
below.  The  laminae  of  this  ligament  leave  intervals  between  them  for 
the  passage  of  blood-vessels. 

Beneath  the  anterior  vertebral  ligament  are  found  a  great  many  short 
and  insulated  ligamentous  fibres,  extended  obliquely  from  one  vertebra 
to  another  which  is  contiguous.  These  fibres  have  different  directions, 
and  cross  each  other  at  acute  angles ;  they  adhere  very  closely  to  the 
fibro-cartilaginous  matter,  and  leave  interstices  between  themselves, 
through  which  the  anterior  vertebral  ligament  adheres  to  the  same  sub- 
stance. Moreover,  there  are,  at  the  sides  of  the  bodies  of  the  vertebrse, 
a  number  of  short  straight  fibres,  passing  from  the  edge  of  the  bone 
above  to  the  edge  of  the  bone  below. 

3.  Posterior  Vertebral  Ligament  (Lig amentum  Commune  Posterius, 
Ligament  Vertebral  Posterieur). — This  is  placed  on  the  hind  part  of 
the  bodies  of  the  vertebrse,  within  the  spinal  canal,  and  extends  from 
the  cuneiform  process  of  the  occiput,  just  beyond  the  foramen  magnum, 
to  the  os  coccygis.  It  is  more  narrow  and  thick  in  the  thoracic  verte- 
brse than  elsewhere.  At  each  inter- vertebral  substance  it  increases  in 
breadth  and  adheres  more  closely,  whereas,  opposite  the  body  of  a 
vertebra  it  is  narrower  and  more  loose,  by  which  arrangement  a  kind 
of  serrated  or  unequal  edge  is  formed  on  each  side. 

This  ligament  is  more  membranous  and  uniform  in  texture  than  the 
anterior,  and  presents  a  smooth,  shining  surface,  resembling  a  tendi- 
nous expansion.  Its  fibres,  also,  do  not  run  individually  the  whole 
length  of  the  spine,  but  are  in  laminae ;  the  more  superficial  of  which 


LIGAMENTS  OF  THE  SPINE.  273 

Fig.  80. 


A  posterior  view  of  the  Spinal  Canal,  half  of  which  has  been  cut  away  in  order  to  show  its  inte- 
rior.— 1,1.  The  inter-vertebral  substance.  2,2.  Surfaces  of  the  vertebra  from  which  the  bony  bridges 
have  been  removed.  3.  The  posterior  vertebral  ligament.  4.  An  opening  for  one  of  the  vertebral 
Veins, 

have  their  fibres  inserted  into  the  fourth  or  fifth  inter-vertebral  sub- 
stance or  vertebra,  below  their  origin.  The  middle  laminae  are  in- 
serted into  the  second  or  third  below,  and  the  deeply  seated  into  the 
first  below.  The  blood-vessels  do  not  penetrate  the  ligament,  but  pass 
by  its  sides  into  the  vertebrae.  The  superior  extremity  of  this  liga- 
ment going  from  the  second  vertebra  to  the  margin  of  the  foramen 
magnum,  is  sometimes  considered  as  distinct. 

Ligaments  of  the  Processes  of  the  Vertebrae. 

1.  Articulation  of  the  Oblique  Processes. — These  processes  are  faced 
with  cartilage,  and  a  synovial  capsule  is  displayed  upon  them  so  as  to 
shut  up  completely  the  cavity  of  the  articulation.     The  capsular  liga- 
ment is  not  uniform  and  fully  developed,  but  is  represented  by  a  few 
irregular  fibres,  passing  from  one  bone  to  the  other. 

2.  Articulation  of  the  Spinous  Processes. — With  the  exception  of 
the   neck,  ligamentous    fibres  (ligamenta  mterspinalia]  are  found  to 
occupy  the  spaces  between  all  the  spinous  processes,  by  passing  their 
whole  length  from  the  spinous  process  above  to  the  spinous  process 
below.     Muscles  supply  largely  their  places  in  the  neck,  and  to  some 
degree  in  the  upper  part  of  the  thorax.     These  ligaments  have  much 
of  a  cellular  structure  above,  but  in  their  descent   they  become  more 
compact,  ligamentous  and  large,  till,  in  the  loins,  they  assume  a  very 
decided  character,  and  have  a  quadrilateral  shape. 

At  the  extremities  of  the  spinous  processes,  there  is  a  ligamentous 
band  (lig,  apicum)r  belonging  to  the  dorsal  and  lurubar  vertebrae. 
Commencing  at  the  seventh  cervical,  in  connection  with  the  Liga- 
mentum  Nuchae,  it  terminates  on  the  spinous  processes  of  the  sacrum. 
It  is  thin  in  the  back,  but  on  the  loins  it  is  very  thick,  and  so  blended 
with  the  tendinous  origins  of  the  muscles,  that  it  is  not  very  dis- 
tinguishable from  them.  The  fibres  of  which  it  consists  are  of  unequal 
VOL.  I. — 18 


274  SKELETON. 

lengths,  being  extended  between  two,  three,  four  or  five  vertebrae,  ac- 
cordingly as  the  fibres  are  superficial  or  deep-seated. 

3.  Owing  to  the  shortness  of  the  spinous  processes  of  the  neck,  an 
arrangement  exists    there   called  Ligamentum  Nuchse   (ligament   cer- 
vical), or  the  Descending  Ligament  of  Diemerbroeck.     This  ligament, 
though  continuous  with  the  one  last  described,  may  be  considered,  for 
the  sake  of  perspicuity,  as  distinct.     It  begins,  therefore,  at  the  seventh 
cervical  spinous  process,  ascends  between  the  muscles  of  the  opposite 
sides  of  the  neck,  and  is  inserted  into  the  posterior  occipital  protuber- 
ance.    It  is  blended  very  much  with  the  tendons  of  muscles,  and  is 
distinguished  from  them  with  some  difficulty,  occasionally.     Its  pos- 
terior margin  is  thick,  but  the  anterior  is  a  thin  membranous  expansion, 
which  runs  to  the  ends  of  the  spinous  processes  of  the  cervical  verte- 
brae, and  to  the  vertical  ridge  (crista  occipitalis)  of  the  occipital  bone, 
leading  from  the  occipital  protuberance  to  the  foramen  magnum.     The 
ligamentum  nuchae,  therefore,  forms  a  complete  septum  between  the 
muscles  of  the  opposite  sides  of  the  neck,  and  is  continuous  with  the 
sheaths  in  which  they  play. 

In  quadrupeds  it  is  remarkably  strong,  but  in  man,  who  from  the 
proportions  of  his  head  and  his  erect  position,  keeps  the  head  nearly 
in  equilibrium,  it  is  comparatively  feeble.  Much  yellow  elastic  liga- 
mentous  material  is  found  in  its  composition. 

4.  Articulation  of  the  Bony  Bridges  of  the  Vertelrse. — The  intervals 
between  the  vertebrae,  at  the  posterior  part  of  the  spinal  canal,  are 

Fig.  81. 


An  internal  view  of  the  Bony  Bridges  of  the  Vertebra,  after  their  separation  from  the  bodies  of  the 
bones.— 1,  1.  One  pair  of  the  ligamenta  flava,  or  yellow  ligaments.  2.  The  capsular  ligament  of  one 
side. 

filled  up  by  the  Yellow  Ligaments  (ligamenta  flava  or  subflava),  so 
called  from  their  peculiar  color.  These  intervals  exist  between  all  the 
true  vertebrae,  being  bounded  laterally  by  their  oblique  processes,  and 
are  very  considerable  in  the  loins,  particularly  that  below  the  last 
vertebra.  They  are  not  so  large  in  the  neck ;  are  still  smaller  in 
the  back;  their  shape  varies  considerably  in  the  several  portions  of 
the  spine. 

The  yellow  ligaments  are  two  in  number,  forming  a  pair,  in  each  of 
these  intervals :  the  two  approach,  behind,  at  an  angle,  in  a  line  with 
the  spinous  processes,  but  are  kept  separated  by  a  small  vertical  fissure 


LIGAMENTS  OF  THE  SPINE. 


275 


filled  up  with  cellular  substance.  They  extend  to  the  oblique  processes 
laterally;  are  connected  to  the  anterior  face  of  the  bony  bridge  of  the 
vertebra  above  ;  whereas,  they  are  inserted  into  the  superior  margin  of 
that  of  the  vertebra  below.  From  this  arrangement,  the  yellow  liga- 
ments may  be  best  seen  on  the  inside  of  the  spinal  canal.  The  angle 
which  they  form  behind  is  continuous  with  the  ligaments  between  the 
spinous  processes. 

These  yellow  ligaments  are  smooth  and  shining  on  their  anterior 
surfaces,  but  behind  they  are  rough  and  unequal.  Their  fibres  are 
numerous  and  extremely  compact ;  their  strength  is,  therefore,  very 
great.  Their  elasticity  is  well  marked  and  assists  greatly  in  erecting 
the  spine  when  it  has  been  curved  out  of  the  proper  line.  Bichat  says 
that  there  is  but  little  cellular  tissue  between  their  fibreg :  that  they 
are  dissolved  with  extreme  difficulty  in  boiling  water,  and  resist  its 
action  to  such  a  degree,  that  it  is  manifest  they  contain  much  less 
gelatin  than  the  greater  number  of  analogous  organs.  They  are  among 
the  purest  examples  of  the  elastic  ligamentous  tissue. 

The  first  pair  of  yellow  ligaments  is  between  the  second  and  third 
cervical  vertebrae,  and  the  last  between  the  last  lumbar  and  the  sacrum; 
there  are,  consequently,  only  twenty-three  pairs  in  all. 

Particular  Articulations  of  the  Spine. 

1.  Articulation  of  the  Occiput  with  the  Atlas. — The  Anterior  Liga- 
ment is  placed  at  the  anterior  part  of  the  occipital  foramen,  and  extends 

Fig.  82. 


An  anterior  view  of  the  Ligaments  connecting  the  Atlas  and  Dentata  with  the  Os  Occipitis.  The 
basilar  process  of  the  occipital  bone  and  the  petrous  portion  of  the  temporal  being  divided  by  the  saw. 
1.  Central  fasciculus.  2.  The  membrana  annuli  anterioris  of  Caldani.  3.  The  commencement  of  the 
anterior  vertebral  ligament.  4,  5.  The  capsular  ligament  of  the  oblique  processes  of  the  atlas  and 
dentata.  6.  The  joint  between  the  first  and  second  cervical  vertebra,  after  the  removal  of  the  capsular 
ligament.  7.  The  outer  fibres  of  the  rnembrana  annuli  anterioris. 

from  it  to  the  corresponding  edge  of  the  atlas.  On  its  centre  in  front 
is  a  fasciculus,  which,  being  narrow  and  somewhat  rounded,  descends 
from  the  middle  of  the  cuneiform  process  to  terminate  in  the  tubercle 
on  the  front  of  the  atlas,  and  consists  in  parallel  fibres  ;  some  of  its 
fibres  run  into  the  anterior  vertebral  ligament.  The  remainder  is  called 
by  Caldani,  Membrana  annuli  anterioris  atlantis  (ligament  occipito- 
atloidien  anterieur).  It  occupies  and  shuts  up  the  whole  space,  between 
the  basilar  process  of  the  os  occipitis,  from  which  it  takes  its  origin 


276  SKELETON. 

*****    L  Fig.  83. 


A.  posterior  view  of  the  Articulation  of  the  Occiput,  At'as  and  Dentata.  1.  The  atlas.  2.  The 
dentata.  3.  Membrana  annuli  posterioris.  4.  The  capsular  ligament  of  the  oblique  processes  of  the 
atlas  and  the  condyles  of  the  occipital  bone.  5.  The  ligament  between  the  first  and  second  vertebrae, 
representing  a  yellow  ligament,  but  more  loose  in  texture.  6.  The  lateral  fasciculi  of  the  same.  7. 
The  first  of  the  yellow  ligaments.  8.  The  capsular  ligament  between  the  oblique  processes  of  the 
second  and  third  vertebrae . 

near  the  occipital  foramen,  and  the  anterior  arch  of  the  atlas,  into  the 
superior  margin  of  which  it  is  inserted.  In  it  are  many  oblique  fibres, 
which  run  from  within  outwards. 

The  Posterior  Ligament  is  placed  at  the  back  part  of  the  occipital 
foramen,  and  extends  from  it  to  the  corresponding  edge  of  the  atlas.  It 
is  called  by  Caldani,  Membrana  annuli  posterioris  atlantis  (ligament 
oecipito-atloidien  posterieur),  and  arising  from  the  whole  posterior  margin 
of  the  occipital  foramen  between  the  condyles,  it  is  extended  to  the  upper 
contiguous  margin  of  the  atlas,  so  as  to  fill  up  completely  this  space. 
Bichat  says  that  it  also  consists  in  two  laminae,  the  anterior  of  which  is 
fibrous,  and  runs  into  the  dura  mater  of  the  spine  instead  of  into  the 
bone :  the  posterior  is  of  a  much  looser  texture,  and  resembles  common 
cellular  substance.  A  part  of  this  membrane  runs  obliquely  from  the 
transverse  process  of  the  atlas  to  the  part  of  the  occiput  just  beneath 
the  insertion  of  the  rectus  posticus  minor.  There  is  a  good  deal  of  the 
yellow  elastic  tissue  in  both  the  anterior  and  posterior  membrana  annuli. 

The  articulating  surfaces  of  the  condyles  of  the  occipital  bone,  and 
of  the  superior  oblique  processes  of  the  first  vertebra,  are  covered  with 
cartilage,  and  furnished  with  a  synovial  membrane  arising  from  their 
margins.  On  the  exterior  of  the  synovial  membrane  there  are  irregular 
ligamentous  fibres  going  between  the  bones,  and  forming  a  capsule. 

2.  Articulation  of  the  second  Vertebra  with  the  Occiput,  and  with 
the  first. — The  second  vertebra  has  no  articular  surface  joining  the 
occiput,  but  some  strong  ligaments  are  passed  between  them.  When 
the  posterior  vertebral  ligament  is  removed  at  its  commencement  from 
the  occipital  bone,  we  see  on  each  side  of  it,  and  beneath  it,  ligament- 
ous bands  (lacerti  ligamentosi),  coming  from  the  internal  face  of  the 
os  occipitis,  to  be  affixed  to  the  body  of  the  second  vertebra  behind. 
Some  of  these  fibres  arise  from  the  margin  of  the  occipital  foramen, 
and  others  from  the  internal  face  of  the  condyloid  processes.1  They 
are  joined  at  their  external  margins  by  a  few  fibres  from  the  first  ver- 
tebra, near  its  upper  oblique  process. 

1  Caldani,  Icon.  Anat.  Explicatio,  vol.  i.  p.  255. 


LIGAMENTS  OF  THE  SPINE.  277 

The  Transverse  Ligament  (ligamentum  transversale  atlantis,  liga- 
ment transversal)  is  placed  immediately  behind  the  processus  den- 
tatus,  and  divides  the  atlas  into  two  unequal  rings  by  being  stretched 
from  one  side  to  the  other.  It  is  larger  in  the  middle  than  at  the 

Fig.  84. 


A  posterior  view  of  the  Ligaments  connecting  the  Atlas  and  the  Dentata  with  the  Occipital  Bone. 
1.  The  upper  part  of  the  posterior  vertebral  ligament.  2.  The  transverse  ligament.  3,  4.  The  upper 
and  lower  appendices  of  the  transverse  ligament.  5.  One  of  the  moderator  ligaments.  6,7.  Capsular 
ligaments  belonging  to  the  oblique  processes  of  the  first  and  second  vertebrse. 

extremities,  and  has  the  latter  inserted  into  the  little  tubercle  at  the 
internal  side  of  the  atlas,  between  the  upper  and  the  lower  articular 
surfaces.  It  is  a  thick,  strong  fasciculus  of  fibres,  and  binds  the  pro- 
cessus dentatus  so  as  to  form  for  it  a  sort  of  collar,  amounting  to  about 
one-fourth  of  a  circle.  The  superior  appendix  of  this  ligament  arises 
by  a  broad  base  from  the  anterior  margin  of  the  foramen  magnum,  and 
terminates  below  by  a  narrow  end  in  the  upper  margin  of  the  trans- 
verse ligament.  The  inferior  appendix  arises  from  the  lower  edge  of 
the  transverse  ligament,  and  is  attached,  by  a  somewhat  converging 
end,  into  the  posterior  face  of  the  body  of  the  vertebra  dentata. 

The  surfaces  of  contact  belonging  to  the  processus  dentatus,  and  to 
the  anterior  ring  of  the  atlas,  are  covered  with  cartilage,  and  have  a 
synovial  membrane,  so  as  to  form  a  perfect  joint  called  the  Vaginal 
ligament.  A  joint  with  a  distinct  synovial  membrane  is,  in  like  man- 
ner, formed  between  the  posterior  face  of  the  processus  dentatus  and 
the  anterior  of  the  transverse  ligament,  where  they  come  into  contact. 

The  Oblique  or  Moderator  Ligaments  (lig.  later  alia,  ligamens 
odontoidiens)  are  two,  one  on  either  side  of  the  tooth-like  process. 
They  may  be  seen  most  advantageously  by  cutting  through  the  trans- 
verse ligament,  and  arise  from  the  side  and  summit  of  the  processus 
dentatus,  to  be  inserted  into  the  internal  margin  of  the  occipital  con- 
dyle.  They  are  thick,  short,  and  strong,  and  consist  in  parallel  fibres; 
their  lower  margin  has  been  considered  as  a  distinct  ligament  by 
Weitbrecht,  and  described  by  him  as  coming  from  the  neck  of  the  pro- 
cess. There  is  some  cellular  tissue  at  the  front,  in  which  the  process 
revolves. 

The  Middle  Straight  Ligament  (lig.  medium  rectum  ligament 
droit  moyeri),  or  Occipito-Dentate,  arises  from  all  that  part  of  the 
summit  of  the  processus  dentatus  anteriorly  which  is  between  the  mode- 


278  SKELETON. 

rator  ligaments,  and  is  inserted  into  all  that  part  of  the  interior  cir- 
cumference of  the  foramen  magnum  between  the  insertion  of  the 
moderator  ligaments.  It  is  a  thin  ligamentous  membrane,  disposed  to 
forjn  in  its  middle  a  vertical  fissure,  separating  its  two  halves.  It  can- 
not be  seen  well,  unless  the  whole  membrana  annuli  anterioris  be  dis- 
sected away,  and  the  anterior  bridge  of  the  first  vertebra  sawed  off;  it 
will  then  be  found  immediately  behind  the  bursa  or  vaginal  ligament 
of  the  processus  dentatus.  It  is  separated  from  the  superior  appendix 
of  the  transverse  ligament  by  a  layer  of  condensed  fatty  substance. 
This  ligament  should  not  be  confounded  with  the  superior  appendix  of 
the  transverse  ligament,  nor  with  the  beginning  of  the  posterior  verte- 
bral ligament,  as  has  been  done  by  Bichat  and  others.  The  difference 
is  well  established  by  Caldani,  as  it  lies  deeper  than  either  of  them  when 
viewed  from  the  vertebral  cavity;  though,  from  the  close  connection  of 
the  fibres  of  the  ligaments  among  themselves,  as  well  as  with  others, 
the  mistake  may  readily  occur.1 

The  Articulation  between  the  oblique  process  of  the  first  and  of  the 
second  cervical  vertebra  is  very  movable,  as  the  atlas  is  permitted  to 
revolve  around  the  processus  dentatus  to  the  amount  of  one-fourth  of  a 
circle  at  least.  This  articulation  has  a  synovial  capsule  which  is 
strengthened  by  an  anterior  and  by  a  posterior  ligament. 

The  anterior  ligament  of  the  articulation  between  these  oblique  pro- 
cesses arises  from  the  inferior  margin  of  the  atlas  and  from  its  anterior 
tubercle,  and  is  inserted  into  the  base  of  the  processus  dentatus,  and 
into  the  front  of  the  body  of  the  second  vertebra.  The  fibres  of  the 
latter  insertion  are  long  and  frequently  distinct  from  the  first. 

The  posterior  ligament  is  placed  between  the  first  and  second  verte- 
brae, behind,  and  is  connected  to  their,  contiguous  margins  so  as  to  fill 
up  the  interval  between  them,  and  to  supply  the  place  of  the  yellow 
ligaments.  It  is  extremely  loose  and  thin,  so  as  not  to  interfere  in 
the  movements  of  the  vertebrae,  and  is  of  a  fibro-cellular  structure. 

The  synovial  membrane  of  these  oblique  processes  is  unusually  lax, 
and  is  reflected  from  the  margin  of  the  one  articular  surface  to  the 
other.  It  is  in  contact  in  front  with  the  anterior  ligament;  behind 
with  the  posterior  and  with  much  cellular  substance ;  internally  with 
the  ligaments  within  the  spinal  canal,  and  externally  with  the  carotid 
artery.  The  latter  obtains  from  it  a  serous  covering,  without  which, 
according  to  Bichat,  it  would  be  bathed  in  the  synovial  fluid. 

1  Its  existence  is,  however,  scarcely  to  be  considered  uniform,  as  it  is  often  wanting  where 
the  processus  dentatus  is  very  long,  for  example,  when  it  reaches  the  anterior  part  of  the 
foramen  magnum  and  forms  a  joint  there,  as  it  sometimes  does. 


LIGAMENTS  OF  THE  PELVIS.  279 


CHAPTER  VII. 
OF  THE  LIGAMENTS  OF  THE  PELVIS. 

THE  mode  of  junction  between  the  sacrum  and  the  last  lumbar  ver- 
tebra is,  in  every  respect,  the  same  as  that  described  for  the  bones  of 
the  spine  generally,  with  the  addition  of  a  ligament  on  each  side, 
sometimes  met  with,  called  Sacro-vertebral,  which  arises  from  the  su- 
perior part  of  the  sacrum  by  blending  itself  with  the  anterior  fibres  of 
the  sacro-iliac  junction,  and,  going  obliquely  upwards,  is  inserted  into 
the  transverse  process  of  the  last  lumbar  vertebra. 


A  posterior  view  of  the  Ligaments  of  the  Pelvis.  1.  Base  of  the  sacrum.  2.  The  coccyx.  3,3. 
The  crista  ilii.  4,4.  The  tuber  ischii.  5,5.  The  greater  sciatic  notch.  6.  The  lesser  sciatic  notch. 
7.  The  femur.  8.  The  posterior  portion  of  the  sacro-iliac  ligament.  9.  The  sacro-spinous  ligament. 
10.  The  posterior  sacro-coccygeal  ligament  in  its  whole  length.  11.  The  obturator  ligament. 
12.  The  obturator  foramen.  13,  13.  The  origin  of  the  greater  sacro-sciatic  ligament.  14.  Its  insertion. 
15.  The  origin  of  the  lesser  sacro-sciatic  ligament.  16.  Its  insertion. 

The  Sacrum  is  united  to  the  coccyx  by  a  fibro-cartilaginous  sub- 
stance, resembling  that  between  the  bodies  of  the  true  vertebrae  with 
the  exception  of  there  being  less  pulpy  matter  in  its  centre,  and  of  its 
fibrous  lamellae  being  more  uniform.  The  bones  of  the  coccyx  are 
also  united  with  one  another  in  the  same  way  ;  in  consequence  of  which 
they  are  very  flexible  till  the  approach  of  old  age.  A  regular  articular 
cavity  is  not  unfrequently  formed  between  the  sacrum  and  coccyx. 

The  Anterior  Coccygeal  Ligament  (lig.  sacro-coccygeum  anterius) 
is  placed  on  the  fore  part  of  the  coccyx ;  runs  its  whole  length,  and 
arises  from  the  inferior  extremity  of  the  sacrum.  Its  fibres  are  rather 
indistinct,  from  their  being  blended  with  fat ;  on  the  lateral  margins  of 
the  coccyx  they  are  better  marked. 


280  SKELETON. 

The  Posterior  Coccygeal  Ligament  (lig.  sacro-coccygeum  posterius\ 
as  its  name  implies,  is  placed  on  the  back  part  of  the  coccyx.  It 
arises  from  the  inferior  margin  of  the  spinal  canal  of  the  sacrum,  and 
forms  a  sort  of  membranous  expansion,  which  covers  and  adheres  to 
the  first  bone  of  the  coccyx,  and  is  also  inserted  into  the  second.  It 
may  be  viewed  as  an  extension  of  the  ligament  at  the  end  of  the  spin- 
ous processes  of  the  Sacrum,  and  finishes  off  the  sacral  canal  behind  so 
as  to  close  it.  There  are  also  a  few  other  ligamentous  fibres  connecting 
the  bones  of  the  coccyx. 

The  Ilio-Lumbar  Ligament  (lig.  ilio-lumbare]  arises  from  the  crista 
of  the  ilium  for  two  inches  near  the  lumbar  vertebrae,  and  passing  in- 
wards is  inserted  into  the  transverse  process  of  the  last  lumbar  vertebra, 
and  into  its  inferior  oblique  process.  It  is  often  blended  with  adipose 
matter,  which  separates  it  into  several  fasciculi.  Caldani  describes  it 
as  two  ligaments,  making  a  distinction  between  the  one  part  fixed  to 
the  transverse,  and  the  other  to  the  oblique  process. 

The  Sacro-Iliac  Articulation  is  formed  by  the  corresponding  surfaces 
of  the  sacrum  and  ilium.  Each  bone  is  incrusted  with  its  own  carti- 
lage, the  one  on  the  sacrum  being  somewhat  more  thick.  Their  sur- 
faces are  slightly  rough,  and  between  them  exists  a  thick  yellow  fluid 
in  a  very  small  quantity,  which  lubricates  them,  and  is  more  abundant 
in  early  life. 

The  Sacro-spinous  Ligament  (lig.  sacro-spinosum)  is  placed  super- 
ficially on  this  articulation  behind.  It  is  very  strong,  flat,  long,  and 
perpendicular.  It  consists  of  two  laminae,  of  which  the  more  super- 
ficial arises  from  the  fourth  transverse  process  or  piece  of  the  sacrum, 
and  is  inserted  into  the  posterior  superior  spinous  process  of  the  ilium. 
The  deep-seated  lamina  arises  from  the  third  transverse  process  or  piece 
of  the  sacrum,  and  is  inserted  into  the  same  point.  Bichat  describes, 
connected  with  the  inferior  margin  of  this  ligament,  a  fasciculus,  which 
adheres  to  the  posterior  inferior  spinous  process  of  the  ilium. 

The  Sacro-Iliac  Ligament  (lig.  sacro-iliacum)  is  next  to  the  arti- 
cular faces  of  the  bones.  It  surrounds  the  joint,  but  is  much  stronger 
on  its  posterior  face.  It  consists  in  an  assemblage  of  ligamentous 
fasciculi,  some  of  which  have  obtained,  by  the  writers  on  Syndesmology, 
particular  names,  but  which  it  would  scarcely  add  to  the  student's  in- 
formation to  designate.  On  the  front  of  the  joint  this  ligament  is 
uniform,  and  consists  of  a  plane  of  short  strong  fibres,  passing  from 
the  margin  of  one  bone  to  that  of  the  other.  But,  on  the  posterior 
surface,  it  is  much  more  irregular,  and  arises  from  the  first  two  pieces 
of  the  sacrum,  by  the  eminences  corresponding  with  the  transverse 
processes  of  the  true  vertebrae,  and  from  that  surface  of  the  sacrum 
between  its  articular  face  and  these  eminences.  From  thence  the  sacro- 
iliac  ligament  goes  to  be  inserted  into  the  rough  surface  of  the  ilium, 
immediately  behind  its  articular  face ;  it  fills  up  there  a  considerable 
space,  and,  from  its  position,  must  be  extremely  irregular.  Its  strength 
is  so  great  that  in  forcing  the  joint  the  ligament  does  not  rupture,  but 


LIGAMENTS  OF  THE  PELVIS.  281 

parts  preferably  from  the  surface  of  the  ilium,  and  sometimes  brings 
with  it  a  lamella  of  bone. 

The  bones  of  the  pelvis  are  also  fastened  by  two  other  very  strong 
ligaments,  the  sacro-sciatic. 

The  Posterior  Sacro-Sciatic  (lig.  sacro-ischiadicum  majus)  is  the 
most  considerable  of  the  two.  It  arises  from  the  posterior  inferior 
spinous  process  of  the  ilium,  from  the  margin  of  the  sacrum  below  this 
bone,  and  somewhat  from  its  posterior  surface,  and  from  the  first  bone 
of  the  coccyx.  It  goes  downwards  and  outwards,  becomes  thicker  in 
its  middle,  but  narrow ;  it  then  spreads  out  and  is  inserted  along  the 
internal  margin  of  the  'tuberosity  of  the  ischium.  Its  anterior  ex- 
tremity is  extended  along  the  internal  face  of  the  crus  of  the  ischium 
for  some  distance,  and  has  the  obturator  internus  muscle  adhering  to 
it.  Its  fibres,  where  they  converge  from  their  origin,  are  separated 
into  planes  by  bits  of  fat,  and  by  blood-vessels. 

The  Anterior  Sacro-Sciatic  Ligament  (lig.  sacro-ischiadicum  minus) 
is  much  smaller  than  the  other,  and  is  placed  in  front  of  it.  It  arises 
from  the  margin  and  somewhat  from  the  posterior  surface  of  the  sacrum 
below  the  ilium,  and  from  the  lateral  margin  of  all  the  bones  of  the 
coccyx.  The  fibres  converge  and  are  inserted  into  the  spinous  process 
of  the  ischium  by  embracing  it.  The  fibres  constituting  its  base  have 
their  fasciculi  separated  by  cellular  adipose  matter  and  by  vessels,  and 
are  also  intermingled  with  the  fibres  of  the  coccygeus  muscle,  and  of 
the  posterior  sacro-sciatic  ligament. 

The  two  sacro-sciatic  ligaments  supply,  in  some  degree,  the  place  of 
bone,  and  form  a  part  of  the  inferior  lateral  parietes  of  the  pelvis. 
They  convert  the  sciatic  notch  into  a  foramen,  or  rather  form  with  it 
two  foramina ;  the  upper  and  larger  of  which  transmits  the  pyriformis 
muscle,  the  sciatic  nerve  and  the  gluteal  blood-vessels,  while  the  lower, 
placed  between  the  insertion  of  the  two  ligaments,  transmits  the 
obturator  internus  muscle,  and  re-conducts  the  internal  pudic  artery 
into  the  pelvis. 

The  Obturator  Ligament  (membrana  obturatoria)  is  extended 
across  the  foramen  thyroideum,  so  as  to  close  it  up,  with  the  exception 
of  a  foramen  at  its  upper  part,  for  transmitting  the  obturator  vessels 
and  nerves.  It  is  a  thin  but  strong  membrane,  having  its  fasciculi  of 
fibres  passing  in  various  directions,  and  arising  from  the  margin  of 
the  foramen.  It  affords  origin  to  many  of  the  fibres  of  the  obturator 
muscles.  Frequently  portions  of  it  are  very  defective. 

The  Articulation  or  Symphysis  of  the  Pubes  is  formed  between  the 
bodies  of  the  two  ossa  pubis.  It  consists  principally  in  a  fibro-cartilagi- 
nous  matter,  which  has  a  strong  resemblance  to  that  of  the  vertebrae, 
but  is  destitute  of  its  pulp.  When  the  bones  are  torn  apart  by  forcing 
them  forwards,  the  fibrous  arrangement  becomes  very  apparent,  and  is 
seen  to  consist  in  concentric  lamellae,  the  fibres  of  which  cross  one 
another.  Sometimes  in  the  male,  but  most  frequently  in  the  female, 
the  posterior  third  of  the  articulation  is  deprived  of  these  fibres,  in 


282  SKELETON. 

place  of  which  we  find,  in  the  middle  of  the  cartilage,  a  small  longi- 
tudinal cavity,  the  surface  of  which  is  smeared  with  a  kind  of  mucosity. 
On  the  posterior  surface  there  is  often  a  ridge  projecting  into  the  cavity 
of  the  pelvis.  From  frequent  observations  made  in  our  dissecting-rooms, 
I  have  no  doubt  that  this  articulation  is  always  very  much  relaxed  in 
the  parturient  and  pregnant  female,  which  is  manifested  not  by  the 
bones  separating,  but  by  their  sliding  upwards  and  downwards  with 
great  readiness.  The  sacro-iliac  junction  also  becomes  relaxed.  It 
was  upon  the  observation  of  these  facts  that  the  celebrated,  but  now 
exploded,  Sigaultian  operation  was  founded. 

The  Anterior  Pubic  Ligament  is  not  very  distinct.  It  lies  in  front 
of  the  last  articulation,  and  consists  in  a  few  oblique  and  transverse 
fibres,  going  from  the  one  bone  to  the  other. 

The  Sub  or  Inter-Pubic  Ligament  (lig.  pubis  irtferius)  occupies  the 
summit  of  the  arch  of  the  pelvis.  It  is  of  a  triangular  form,  about  half 
an  inch  in  breadth,  and  passes  from  the  margin  of  the  crus  of  the 
pubes  of  the  one  side  to  a  corresponding  line  on  the  other.  It  is 
remarkably  strong,  and  is  rather  more  so  below  than  above.  It  is 
rather  an  extension  of  the  ligament  of  the  symphysis  pubis  than  a 
distinct  structure. 


CHAPTER  VIII. 
ARTICULATIONS  OF  THE  THORAX. 
Posterior  Articulations  of  the  Ribs. 

As  mentioned,  in  the  account  of  the  bones,  the  articulations  here 
are  double  ;  being  formed  at  one  point  between  the  head  of  the  ribs . 
and  the  bodies  of  the  vertebrae  with  the  inter-vertebral  plate  ;  and  at 
the  other,  between  the  tubercle  of  the  ribs  and  the  transverse  process 
of  the  vertebrae.  In  either  case  the  respective  surfaces  are  covered  by 
articular  cartilage,  and  have  a  synovial  membrane.  The  first  joint  is 
the  Costo-vertebral,  and  the  second  the  Costo-transverse. 

1.  The  Costo-vertebral  articulation  presents  an  anterior  ligament, 
an  inter-articular  ligament,  and  two  synovial  membranes.  The  Ante- 
rior or  Radiating  Ligament  (lig.  capituli  costarum)  is  fixed,  as  its 
name  expresses,  in  front  of  the  joint.  It  arises  from  the  margin  of 
the  head  of  the  rib  by  the  whole  breadth  of  the  latter,  and  diverging 
towards  the  spine,  is  fixed,  by  its  superior  fibres,  into  the  vertebra 
above ;  by  its  inferior  fibres,  into  the  vertebra  below ;  and,  by  its 
middle  fibres,  into  the  inter-vertebral  plate.  It  is  a  thin,  flat,  fibrous 
membrane,  leaving  intervals  in  it  for  the  passage  of  blood-vessels,  and 
may,  indeed,  be  considered  as  a  capsule  to  the  articulation,  and  is  fre- 


ARTICULATIONS  OF  THE  THORAX.  283 

quently  described  as  such.  The  inter-articular  ligament  passes  from 
the  ridge  on  the  head  of  the  rib  to  a  corresponding  line  of  the  inter- 
vertebral  substance.  It  is  short  and  strong,  and  divides  the  articula- 
tion of  the  head  of  the  rib  into  two  cavities,  which  have  no  communi- 
cation. It  is  in  consequence  of  the  latter,  that  there  are  two  synovial 
membranes  to  the  head  of  every  rib  which  has  a  double  articular  face ; 
but  the  ribs  which  are  articulated  with  a  single  vertebra,  as  the  first, 
the  eleventh,  and  twelfth,  have  not  the  inter-articular  ligament,  and, 
therefore,  only  one  synovial  membrane. 

The  synovial  membranes  are  not  very  apparent,  neither  is  the  fluid 
abundant ;  the  cavity  is  occasionally  very  small  from  the  encroach- 
ment of  the  inter-articular  ligament.  Anchylosis  occasionally  takes 
place  here,  but  is  more  rare  than  in  the  anterior  articulations  of  the 
thorax. 

2.  The  Costo-transverse  articulation  has,  in  addition  to  the  joint 
formed  between  the  tubercle  of  the  rib  and  the  end  of  the  transverse 
process,  several  ligamentous  fasciculi  which  pass  in  varied  directions. 

The  synovial  membrane  is  much  more  distinct  than  in  the  preceding 
articulation,  and  contains  more  synovia.  The  joint  is  more  loose,  and 
is  never  anchylosed,  except  by  disease.  There  are  a  few  fibres  around 
it  having  the  semblance  of  a  capsule. 

a.  The  Internal  Transverse  Ligament  (ligamentum  transversarium 
internum,  or  costo-transyersarium  inferius)  arises  from  the  inferior 
margin  of  the  transverse  process,  between  its  root  and  external  extremi- 
ty, and  proceeding  downwards  and  inwards,  is  inserted  into  the  upper 
margin  of  the  neck  of  the  rib  below.     In  many  of  the  ribs  there  is  a 
plane  of  ligamentous  fibres  parallel  with  this  ligament,  but  just  behind 
it,  and  arising  from  a  more  posterior  situation  of  the  transverse  process 
to  go  to  the  neck  of  the  rib,  somewhat  more  towards  the  tubercle  of 
the  latter.     It  is  designated  by  some  writers  as  the  posterior  transverse 
ligament,  but  the  distinction  between  it  and  the  lig.  trans,  internum  is 
so  slight  that  it  scarcely  seems  necessary  to  consider  them  apart.     The 
Internal  Transverse  Ligament  is  much  more  conspicuous  in  the  middle 
eight  ribs,  and  in  extremely  emaciated  subjects ;  in  others,  it  is  ob- 
scured by  cellular  adipose  matter  around  the  heads  of  the  ribs. 

b.  The  External  Transverse  Ligament  (ligamentum  transversarium 
externum,  or  costo-transversarium  posterius)  is  a  well-marked  quad- 
rangular plane  of  ligamentous  fibres,  placed  on  the  posterior  surface  of 
the  costo-transverse  articulation.     It  arises  from  the  extremity  of  the 
transverse  process,  and  going  outwardly,  is  inserted  into  the  proximate 
rib,  just  beyond  its  articular  tubercle. 

c.  The  Middle  Costo-Transverse  Ligament  (ligamentum   cervicum 
costarum,  or  costo-transversarium  medium)  is   extended  between  and 
concealed  by  the  neck  of  the  rib  and  the  contiguous  transverse  pro- 
cess, and  cannot  be  seen  well  without  separating  them,  or  by  sawing 
through  their  length.     It  is  a  collection  of  short  fibres,  somewhat  irre- 
gular, resembling  condensed  cellular  Substance,  and  slightly  red. 

These  posterior  articulations  all  require  a  patient  dissection,  as  they 
are  surrounded  by  small  parcels  of  adipose  matter,  have  the  intercostal 
nerves  and  blood-vessels  in  contact  with  them  before,  and  the  muscles 


284  SKELETON. 

of  the  spine  behind.  The  ligaments  between  the  transverse  processes 
and  the  ribs  are,  of  course,  not  found  in  the  eleventh  and  twelfth,  from 
the  bones  not  touching  there. 

Besides  what  has  been  described,  an  aponeurosis  or  ligamentous  mem- 
brane is  extended  from  the  transverse  process  of  the  first  and  second 
lumbar  vertebrae  to  the  inferior  margin  of  the  last  rib.  A  ligamentous 
membrane  is  also  found  near  the  spine,  extended  between  the  con- 
tiguous margins  of  the  last  two  ribs. 

Anterior  Articulations  of  the  Ribs. 

The  surface  of  each  pit  in  the  side  of  the  sternum  is  covered  by  a 

Fig.  86. 


The  Ligaments  of  the  Sterno-clavicular  and  Costo-sternal  Articulation. — 1.  The  capsu I ar  ligament 
of  the  sterno-clavicular  articulation.  2.  The  inter-clavicular  ligament.  3.  The  costo-clavicular,  or 
rhomboid  ligament.  4.  The  inter-articular  cartilage.  5.  The  anterior  costo-sternal  ligaments  of  the 
first  and  second  ribs. 

thin  cartilaginous  plate,  to  receive  the  corresponding  cartilage  of  the 
rib,  and  the  articulation  presents  an  anterior  and  a  posterior  ligament, 
also  a  synovial  capsule. 

The  anterior  ligament  arises  from  the.  extremity  of  the  cartilage,  and, 
going  over  the  front  of  the  sternum,  radiates  very  considerably  in  every 
direction.  Some  of  its  fibres  are  continuous  with  the  corresponding  fibres 
of  the  opposite  side ;  others  are  lost  in  the  periosteum  and  in  the  ten- 
dinous origin  of  the  great  pectoral  muscle  ;  others  join  the  fibres  of  the 
ligament  above,  and  of  that  below.  The  more  superficial  the  fibres  are, 
the  longer  they  become  ;  but  the  more  deeply  seated  pass  only  from  the 
margin  of  the  cartilage  to  the  margin  of  the  cavity  in  the  sternum. 
The  thick  ligamentous  covering  found  on  the  front  of  the  sternum  may 
be  considered  as  only  the  continuation  of  these  anterior  ligaments.  The 
fibres  from  the  two  lower  articulations  on  the  opposite  sides  form,  by 
their  junction,  a  striking  triangular  ligamentous  plane,  just  on  the  lower 
end  in  front  of  the  second  bone  of  the  sternum.  Besides  which,  there 
are  several  strong  ligamentous  fasciculi  running  in  a  great  variety  of 
directions. 

The  posterior  ligament  has  a  similar  arrangement  with  the  anterior, 
in  the  radiation  of  its  fibres  into  the  contiguous  ligaments,  and  in  their 
origin  from  the  costal  cartilage.  Altogether  they  form,  on  the  poste- 
rior face  of  the  sternum,  a  strong  smooth  covering,  the  fibres  of  which 
do  not  run  in  large  fasciculi,  but  make  a  uniform  polished  membrane, 


ARTICULATIONS  OF  THE  THORAX.  285 

and  are  closely  interwoven  with  each  other.  Some  of  these  fibres  are 
longitudinal,  and,  of  course,  cannot  be  referred  to  the  posterior  liga- 
ments, but  are  independent  of  them. 

The  synovial  membrane,  though  its  existence  is  admitted,  is  not  in  a 
very  distinct  state.  It  scarcely  gives  a  polish  to  the  articular  surfaces, 
and  has  so  little  looseness  in  its  reflection  from  the  one  to  the  other,  as 
to  indicate  clearly  that  but  an  inconsiderable  motion  is  admitted  in 
these  joints.  The  synovia  is  in  very  small  quantity,  not  abundant 
enough  for  satisfactory  examination,  and  its  character  is  rather  in- 
ferred than  proved.  The  first  cartilage  is  continuous  with  the  sternum, 
and  not  separated  from  it  by  any  joint,  except  in  rare  instances.  The 
second  cartilage  has  its  joint  with  the  sternum,  separated  into  two,  one 
above  and  the  other  below,  by  a  ligamentous  partition  resembling  that 
at  the  heads  of  the  ribs.  The  lower  articulations  become,  successively, 
more  movable  than  the  upper. 

Besides  the  attachments  mentioned  as  connecting  the  cartilages  of 
the  true  ribs  to  the  sternum,  there  is  one  superadded  to  the  seventh 
cartilage,  called  the  Costo-Xiphoid  Ligament.  It  arises  from  the  infe- 
rior margin  of  the  seventh  cartilage,  near  the  sternum,  and  going 
obliquely  downwards  and  inwards,  is  inserted  into  the  anterior  face  of 
the  xiphoid  cartilage,  and  has  its  upper  fibres  running  into  the  corre- 
sponding fibres  of  its  fellow.  It  is,  of  course,  placed  behind  the  rectus 
abdominis  muscle,  and  fills  up,  in  some  measure,  the  angle  between  the 
seventh  cartilage  and  the  third  piece  of  the  sternum. 

At  the  surfaces  where  the  sixth  and  seventh  costal  cartilages  come 
into  contact  by  their  edges,  also  the  seventh  and  eighth,  a  synovial 
membrane  exists.  A  similar  articulation  is  sometimes  found  between 
the  fifth  and  sixth,  and  the  eighth  and  ninth  cartilages,  but  not  uni- 
formly. These  synovial  membranes  are  covered  by  a  strong  fibrous 
capsule. 

It  has  been  already  stated  that  the  anterior  extremity  of  the  cartilage 
of  each  of  the  first  three  false  ribs  is  united  by  ligamentous  fibres  to  the 
cartilage  above.  These  ligaments  are  strong  and  extensive,  and  give 
great  solidity  to  the  common  margin  of  the  cartilages.  The  last  two 
cartilages  being  much  smaller  than  the  others,  no  ligaments  pass  from 
them ;  but  they,  with  their  ribs,  are  held  in  their  position  by  the  inter- 
costal and  the  abdominal  muscles. 

The  Costal  cartilages  adhere  very  closely  to  their  respective  ribs, 
which  receive  them  into  the  oblong  fossa  at  their  anterior  extremities. 
The  periosteum  of  the  rib  is  continuous  with  the  perichondrium  of  the 
cartilage  and  the  membrane,  which  is,  in  fact,  one  and  the  same,  ad- 
heres very  closely  to  the  margins  of  the  articulation;  it  is  also  rein- 
forced by  some  ligamentous  fibres  beneath  it.  No  motion  whatever  is 
admitted  at  this  articulation. 


286  SKELETON. 


CHAPTER  IX.  <  ;: 

OF  THE  ARTICULATIONS  OF  THE  UPPER  EXTREMITIES. 

Of  the  Articulations  of  the  Shoulder. 

THESE  articulations  consist  in  the  junction  of  the  clavicle  to  the 
upper  part  of  the  sternum  and  to  the  cartilage  of  the  first  rib ;  of  the 
scapula  to  the  clavicle ;  and  of  the  os  humeri  to  the  scapula. 

Of  the  Sterna- Clavicular  Articulation. 

The  uneven  triangular  face  of  the  internal  end  of  the  clavicle,  and 
the  concavity  of  the  sternum  at  its  upper  corner,  form  the  surfaces 
which  enter  into  this  articulation.  The  first  is  much  more  extensive 
than  the  articular  surface  of  the  sternum,  projects  on  every  side  beyond 
its  margins,  and  is  very  prominent  in  case  of  extreme  emaciation.  The 
two  surfaces  are  covered  by  cartilage,  of  which  that  on  the  clavicle  is 
the  thickest,  and  serves  to  fill  up  its  inequalities ;  while  the  one  on  the 
sternum  is  thin  and  smooth. 

The  joint  is  invested  by  a  thick  fibrous  capsule,  the  anterior  portion 
of  which  presents  a  strong  fasciculus  of  fibres  somewhat  separated  by 
small  interstices.  This  portion,  the  Anterior  or  the  Radiated  ligament, 
arises  from  the  anterior  extremity  of  the  clavicle,  and,  going  downwards 
and  inwards,  is  inserted  into  the  margin  of  the  articular  cavity  of  the 
sternum.  It  is  placed  just  behind  the  origin  of  the  sterno-cleido-mas- 
toid  muscle.  The  capsular  ligament  is  also,. strengthened  on  its  poste- 
rior surface  by  additional  fibres,  not  so  distinct  as  the  preceding,  but 
obtaining  the  name  of  the  Posterior  ligament. 

The  Inter- Clavicular  Ligament  (lig.  inter-clavicular e}. — Closely  con- 
nected with  the  capsule  of  the  sterno-clavicular  junctions,  this  liga- 
ment is  placed  on  the  superior  end  of  the  sternum,  and  extends  from 
the  internal  end  of  one  clavicle  to  that  of  the  other.  It  is  flat  before 
and  behind,  thin  and  narrow,  is  blended  with  the  contiguous  ligament- 
ous  structure  of  the  sternum,  and  might,  with  propriety,  be  considered 
only  an  appendage  to  the  capsular  ligaments,  or  a  process  sent  between 
them.  In  front  it  corresponds  with  the  integuments,  and  behind  with 
the  sterno-hyoid  muscles. 

The  Inter- Articular  Cartilage. — When  the  capsule  of  the  joint  is 
cut  open,  this  is  brought  into  view.  It  separates  the  bones  completely 
from  each  other  by  its  extent,  and  supplies  by  its  shape  the  want  of 
correspondence  in  their  articular  faces.  It  is  thicker  above  than  below ; 
its  centre  is  thin,  and  sometimes  perforated.  Its  margins  adhere  closely 
to  the  capsular  ligament;  it  is  also  fixed  by  adhesion  to  the  upper  pos- 
terior margin  of  the  surface  of  the  clavicle,  and  below  to  the  union  of 


ARTICULATIONS  OF  THE  UPPER  EXTREMITIES. 


287 


the  sternum  with  the  cartilage  of  the  first  rib;  in  consequence  of  which 
it  has  but  little  motion,  and  in  luxations  must  be  lacerated.  Its  struc- 
ture is  fibro-cartilaginous. 

The  Synovial  Membranes. — There  are  two  of  these,  one  on  each  side 
of  the  inter-articular  cartilage;  in  consequence  of  which  a  double  cavity 
exists  in  this  articulation,  excepting  the  cases  where  the  cartilage  is 
perforated.  These  membranes  contain  but  little  synovia;  they  adhere 
closely  to  the  adjoining  surfaces,  and  cannot  be  made  very  distinct, 
except  in  points  where  there  are  small  interstices  in  the  capsule,  when, 
by  pressing  the  bones  strongly  together,  they  protrude  in  little  vesicles. 

Of  the  Costo- Clavicular  Articulation. — It  consists  in  a  short  fascicu- 
lus of  ligamentous  fibres,  frequently  called  the  Rhomboid  Ligament, 
which,  arising  from  the  upper  surface  of  the  cartilage  of  the  first  rib, 
ascends  obliquely  outwards,  and  is  implanted  into  the  roughness  on  the 
inferior  face  of  the  clavicle,  near  its  sternal  end.  Its  fibres  are  parallel, 
all  oblique,  and  longer  at  its  external  than  at  its  internal  margin.  It 
corresponds  in  front  with  the  origin  of  the  subclavius  muscle,  and  be- 
hind with  the  subclavian  vein.  It  has  for  its  object  the  strengthening 
of  the  junction  of  the  clavicle  with  the  sternum. 

Of  the  Scapulo- Clavicular  Articulations. 

These  exist  at  three  places;  the  first  by  a  junction  between  the 
acromion  scapulae  and  the  external  end  of  the  clavicle ;  and  the  last  two 
by  ligaments  sent  from  the  coracoid  process  to  the  under  surface  of 
the  clavicle. 

The  Acromio- Clavicular  Articulation  presents,  on  each  bone,  a  small 

Fig.  87. 


The  Lignmetl^S  of  the  Acromio-Clavicular  and  Scapulo-Humcral  Articulations.     Front  view  of 
leftside — 1.  The  superior  acromio-elavicular  ligament.    2.  1  he  coraco-clavicular  ligament.     3.  The 
3O-acromial  ligament.    4. '1  he  coracoid  ligament.    5. 'I  hecapsular  ligament 


6.   I  he   ligarnentum  adscititium,  or   coraco-humeral   ligament, 
the  biceps  muscle,  issuing  from  the  capsular  ligament. 


t  of  the  shoulder-joint. 
The  tendon  of  the  long  head  of 


288  SKELETON. 

oblong  face,  covered  with  cartilage.  The  fibrous  capsule  which  in  vests 
it  is  very  strong  and  thick,  so  as  to  give  the  appearance  of  a  much 
greater  extent  to  the  articular  faces  of  the  bones  than  really  exists. 
This  capsule  is  strengthened  by  additional  fibres  on  its  upper  surface, 
passing  from  one  bone  to  the  other,  and  called  the  Superior  ligament: 
they  are  parallel  to  each  other,  and  partially  blended  with  the  tendi- 
nous fibres  of  the  deltoid  and  trapezius  muscles.  The  capsule  is  also 
strengthened  on  its  lower  face  by  additional  fibres,  constituting  the 
Inferior  ligament;  they  are  by  no  means  so  abundant  as  the  superior, 
and  pass  from  the  margin  of  one  bone  to  that  of  the  other,  after  the 
same  manner.  A  synovial  membrane  is  reflected  over  these  articular 
surfaces,  and  contains  but  a  very  small  quantity  of  fluid.  In  some 
instances,  an  inter-articular  fibro-cartilage  is  found  in  this  joint,  as  in 
the  sterno-clavicular;  in  such  case  there  is  a  double  synovial  mem- 
brane. And  in  most  instances  there  is  aa  approach  to  this  arrange- 
ment by  a  ragged  fibrous  fringe  projecting  from  the  capsular  ligament, 
in  a  circular  ring  between  the  bones. 

Of  the  Cor aco- Clavicular  Ligament. — This  ligament  is  double,  one 
part  being  called  the  Conoid  (lig.  conoides\  and  the  other  the  Tra- 
pezoid  (lig.  trapezoides).  It  arises  from  the  roughness  at  the  root  of 
the  coracoid  process,  and  is  attached  to  the  under  surface  of  the  cla- 
vicle. The  conoidal  portion,  having  its  base  upwards,  is  inserted  into 
the  tubercle,  near  the  external  end  of  the  clavicle.  Its  fibres  are 
compact,  strong,  and  diverging.  The  trapezoid  is  placed  at  the  acro- 
mial  side  of  the  other.  It  is  quadrilateral,  longer,  broader,  and  thinner 
than  the  other,  having  its  fibres  separated  by  small  interstices.  Aris- 
ing also  from  the  root  of  the  coracoid  process,  it  is  inserted  into  an 
oblique  line  leading  from  the  tubercle  of  the  clavicle  to  its  acromial 
end.  The  union  of  these  two  portions  behind  forms  a  projecting  angle ; 
in  front  there  is  a  depression  between  them  filled  with  fat  and  cellular 
substance,  also  a  bursa  mucosa.  These  ligaments  are  bounded  in  front 
by  the  subclavius,  and  behind  by  the  trapezius  muscles. 

The  Bifid  Ligament  (ligamentum  bicorne)  is  placed  in  front  of  the 
subclavius  muscle.  It  arises  from  the  root  of  the  coracoid  process,  at 
the  sternal  side  of  the  conoid  ligament:  and  proceeding  with  but  little 
elevation,  inwards  and  upwards,  increases  in  breadth  and  bifurcates. 
The  superior  horn  is  inserted  along  the  under  margin  of  the  clavicle  to 
near  the  rhomboid  or  costo-clavicular  ligament;  but  the  lower  one  goes 
to  the  end  of  the  first  rib,  under  the  tendon  of  the  subclavius  muscle. 
This  ligament  is  a  sort  of  fascia  placed  over  the  subclavius  muscle  to 
bind  and  strengthen  it.1  Some  of  the  fibres  of  the  superior  horn  occa- 
sionally proceed  farther,  and  leaving  the  clavicle,  go  with  the  rhomboid 
ligament  into  the  cartilage  of  the  first  rib.2 

1  This  ligament  is  called  the  clavicular  fascia  by  MM.  Velpeau  and  Blandin,  in  their 
treatises  on  surgical  anatomy. 
*  Caldani,  Plate  xli. 


ARTICULATIONS  OF  THE  UPPER  EXTREMITIES.  289 

Of  the  Scapular  Ligaments. 

The  Coracoid  Ligament  (lig.  coracoideum)  stretches  across  the 
notch  on  the  superior  costa  of  the  scapula,  and  converts  it  into  a  fora- 
men. It  runs  from  the  posterior  margin  of  the  notch  to  the  base  of 
the  coracoid  process,  and  has  some  of  its  fibres  blending  with  the  conoid 
ligament.  It  consists  of  a  small  fasciculus  of  fibres,  and  is  of  very 
little  consequence,  excepting  in  its  relation  to  the  superior  scapular 
vessels  and  nerves. 

The  Triangular  Ligament  (lig.  coraco-acromialis)  of  the  Scapula, 
as  its  name  implies,  extends  from  the  coracoid  to  the  acromion  process 
above  the  shoulder  joint.  It  arises  from  nearly  the  whole  superior 
margin  of  the  coracoid  process,  in  two  divisions,  separated  partially  by 
cellular  tissue.  Its  fibres  converge  in  their  progress,  by  which  it  be- 
comes thicker,  and  is  inserted  into  the  point  of  the  acromion  process, 
just  beneath  its  junction  with  the  clavicle.  This  ligament  is  covered 
by  the  deltoid  muscle  and  the  clavicle,  and  has  the  supra-spinatus 
beneath  it.  Its  anterior  margin  is  continuous  with  a  condensed  cellular 
membrane  beneath  the  deltoid. 

Of  the  Scapulo-Humeral  Articulation. 

The  glenoid  cavity  of  the  scapula,  and  the  head  of  the  os  humeri 
form  this  joint.  As  usual,  each  articular  surface  is  covered  with 
cartilage,  of  which  that  on  the  os  humeri  is  thicker  in  the  middle  than 
near  its  circumference,  while  the  reverse  occurs  on  the  scapula.  From 
the  shallowness  of  the  glenoid  cavity  and  the  much  greater  size  of  the 
head  of  the  os  humeri,  but  very  few  points  of  their  opposed  surfaces 
can  come  into  contact  at  the  same  moment,  though  they  may  all  do  so 
in  succession:  hence  a  considerable  portion  of  the  head  of  the  os 
humeri  is  always  against  the  capsule  of  the  joint.  The  remaining 
parts  of  this  articulation  are  the  capsular  ligament,  the  synovial  mem- 
brane, and  the  glenoid  ligament. 

The  Capsular  ligament  (see  Fig.  87)  invests  completely  this  joint, 
though  it  is  thinner  in  some  places  than  at  others.  It  arises  from  the 
margin  of  the  glenoid  cavity,  and  is  inserted  into  the  neck  of  the  os 
humeri,  including  a  larger  space  of  the  neck  below,  than  it  does  above. 
The  tendons  of  the  muscles  which  arise  from  the  external  and  internal 
surface  of  the  scapula,  to  be  inserted  into  the  tuberosities  of  the  os 
humeri,  as  they  approach  their  points  of  insertion,  adhere  very  closely 
to  the  capsular  ligament,  and  are,  indeed,  more  or  less  blended  with  it. 
Bichat  considers  that  the  tendon  of  the  subscapularis  muscle  supplies 
the  place  of  the  capsular  ligament  entirely  at  its  lower  part.  This 
ligament  is  formed  by  fibres  which  are  very  much  interwoven  with  one 
another,  and  have  a  greater  degree  of  thickness  above  than  below,  or, 
indeed,  at  any  other  point.  The  former  is  due  to  a  thick  fasciculus, 
the  Coraco-Humeral  Ligament,  also  called  by  some,  Ligamentum  Asci- 
titium,  which  takes  its  origin  from  the  posterior  and  external  margin  of 
the  coracoid  process,  and  proceeding  beneath  the  triangular  ligament 
VOL.  i. — 19 


290  SKELETON. 

to  the  upper  part  of  the  os  humeri,  joins  the  capsular  ligament,  and 
adheres  very  firmly  to  it.  This  ligament  keeps  the  head  of  the  os 
humeri  on  its  proper  level  in  regard  to  the  glenoid  cavity;  but  the 
moment  it  is  cut,  the  length  of  the  capsular  ligament  permits  the  head 
of  the  os  humeri  to  fall  about  an  inch,  and,  indeed,  to  suffer  a  partial 
dislocation.  The  strength  of  the  joint,  however,  depends  essentially 
upon  the  muscles  which  surround  it,  as  the  deltoid,  supra-spinatus, 
infra-spinatus,  teres  minor,  subscapularis,  long  head  of  the  triceps, 
and  some  others,  which  are  farther  removed  from  it. 

The  Synovial  membrane  is  a  perfect  sac,  which  covers  the  glenoid 
cavity,  the  internal  face  of  the  capsular  ligament,  and  the  neck  and 
head  of  the  os  humeri.  On  the  lower  part  of  the  neck  it  is  reflected 
over  some  small  fatty  masses,  commonly  called  glands.  Just  beneath 
the  root  of  the  coracoid  process,  from  there  being  a  deficiency  of  the 
capsular  ligament,  the  synovial  membrane  covers  the  articular  side  of 
the  tendon  of  the  subscapularis,  and  is  reflected  for  ten  or  twelve  lines, 
between  it  and  the  scapula,  forming  a  sort  of  pouch,  resembling  a  bursa 
mucosa. 

The  Glenoid  cavity  itself  is  deepened  by  a  fibrous  margin  all  around, 
called  the  Crlenoid  ligament,  a  considerable  part  of  whose  fibres  may 
be  traced  from  the  tendon  of  the  biceps,  by  its  bifurcating.  The  tendon 
of  the  biceps  muscle  runs  through  this  articulation  from  the  superior 
end  of  the  glenoid  cavity,  and  emerges  at  the  lower  end  of  the  bicipital 
groove.  The  tendon  is  bound  down  in  the  bicipital  groove  by  fibres 
passing  from  one  to  the  other  of  the  bony  margins ;  they  may  be  con- 
sidered a  continuation  of  the  capsular  ligament.  As  the  tendon  is 
about  emerging  from  the  groove  at  the  lower  margin  of  the  tuberosities, 
the  synovial  membrane  which  lines  the  groove  thus  far  is  reflected 
from  it  to  the  surface  of  the  tendon,  and  continues  to  cover  and  enclose 
it  up  to  its  origin  at  the  glenoid  cavity.  It  is  thus  evident  that  though 
the  tendon  passes  through  the  joint,  the  cavity  of  the  synovial  mem- 
brane is  kept  entire. 

Of  the  Elbow  Joint. 

This  articulation  is  formed  by  the  lower  end  of  the  os  humeri  and 
the  upper  end  of  the  ulna  and  of  the  radius.  The  articular  faces  which 
were  described  in  the  account  of  these  bones  are  covered,  as  usual,  with 
cartilage,  the  particular  arrangement  of  which  will  be  presently  pointed 
out.  A  strong  capsular  ligament,  an  annular  or  coronary  ligament, 
and  a  synovial  membrane,  hold  these  several  bones  together. 

The  Capsular  ligament  invests  completely  the  articular  extremities 
of  these  bones,  and  conceals  them  from  view.  It  is  attached  to  the 
sides  of  the  os  humeri  at  the  lower  part  of  its  condyles  near  the  arti- 
cular surface,  but  in  front  it  arises  some  distance  from  the  articular 
face  at  the  upper  margins  of  the  sigmoid  cavities,  for  the  head  of  the 
radius  and  for  the  coronoid  process  of  the  ulna :  behind,  it  arises  in 
like  manner  from  the  upper  margin  of  the  cavity  for  receiving  the 


ARTICULATIONS  OP  THE  UPPER  EXTREMITIES. 


291 


olecranon  process  ;  so  that  the  depressions,  both  before  and  behind,  are 
included  within  the  circumference  of  the  articulation.  The  lower  part 
of  the  capsular  ligament  is  inserted  into  the  margin  of  the  articular 
surface  of  the  ulna,  all  around,  including,  also,  the  whole  of  the  head 
of  the  radius,  and  the  upper  part  of  its  neck. 

This  capsule  is  strengthened  very  much  at  particular  points  by  funi- 
cular ligaments,  as  the  coronary  and  lateral,  and  as  the  joint  is  hinge- 
like,  the  strengthening  is  more  abundant  at  its  sides,  by  the  lateral 
ligaments. 

The  External  Lateral,  or  the  Brachio-Radial  ligament  (lig.  cubiti 
externum)  is  connected  above  to  the  lower  part  of  the  external  condyle, 
and  is  fixed  below  into  the  annular  ligament  which  surrounds  the  neck  of 


Fig.  88. 


Fig.  89. 


Fig.  88.  An  external  view  of  the  Elbow  Joint.  Left  arm  from  behind.  1.  The  humerus.  2.  The 
ulna.  3.  The  radius.  4.  The  external  lateral  ligament.  5.  The  coronary  ligament.  6.  The  inser- 
tion of  the  coronary  ligament  at  the  posterior  part  of  the  lesser  sigmoid  cavity  of  the  ulna.  7,  8.  The 
portions  of  the  capsular  ligament  known  as  the  accessory  ligaments.  9.  The  interosseous  ligament 
of  the  fore  arm. 

Fig.  89.  An  internal  view  of  the  Elbow  Joint,  left  arm.  1.  The  capsular  ligament.  2.  The  inter- 
nal lateral  ligament.  3.  The  coronary  ligament.  4.  The  ligamenrum  teres.  5.  The  interoeseoue  liga- 
ment, 6.  The  internal  condyle,  which  conceals  the  capsular  ligament  behind. 

the  radius.  It  is  very  much  connected  with  the  tendinous  mass  common 
to  the  muscles  at  this  part  of  the  arm,  more  particularly  that  of  the  supi- 
nator  radii  brevis.  It  is  a  round  fasciculus  of  parallel  and  condensed 
fibres  spreading  somewhat  below  into  the  annular  or  orbicular  ligament. 
The  Internal  Lateral,  or  the  Brachio-Ulnar  Ligament  (lig.  cubiti  inter- 
mtm)  arises  from  the  lower  part  of  the  internal  condyle,  and  spreading 
out  so  as  to  assume  a  triangular  shape,  divides  into  two  portions,  one  of 
which  is  inserted  into  the  internal  margin  of  the  coronoid  process  of 
the  ulna,  and  the  other  into  the  internal  margin  of  the  olecranon  pro- 
cess. It  also  is  much  blended  with  the  tendons  of  the  muscles  which 
lie  over  it.  Intermediately  to  the  lateral  ligaments,  the  fibrous  struc- 


292  SKELETON. 

ture,  both  before  and  behind,  of  the  capsular  ligament  is  very  distinct, 
but  thin,  in  order  to  accommodate  the  motions  of  the  joint ;  many  of 
the  fibres  are  insulated,  and  have  interstices  between  them  filled  with 
fat.  Some  of  these  fibres  are  oblique,  and  others  straight:  they  are 
called,  in  common,  Accessory  ligaments. 

The  Coronary  Ligament  of  the  Radius  (lig.  radii  orliculare)  is 
brought  more  distinctly  into  view  by  cutting  open  the  joint.  It  is  then 
seen  to  arise  from  the  anterior  margin  of  the  lesser  sigmoid  cavity  of 
the  ulna,  and  surrounding  two-thirds  of  the  neck  of  the  radius,  to  be 
inserted  into  the  posterior  margin  of  the  same  cavity.  It  is  a  strong, 
flat,  narrow  fasciculus,  the  fibres  of  which  go  in  a  circular  direction. 
Its  superior  margin  is  blended  with  the  external  lateral  ligament :  its 
inferior  margin  is  loose,  being  connected  with  the  lower  part  of  the 
neck  of  the  radius  only  by  a  reflection  of  the  synovial  membrane,  with 
the  exception  that  a  few  fibres  pass  from  it  behind,  to  the  contiguous 
part  of  the  ulna.  Its  density  is  very  considerable,  sometimes  almost 
t  cartilaginous. 

The  Synovial  Membrane  lines  the  whole  internal  face  of  the  cap- 
sular ligament,  from  which  it  is  separated  behind  by  a  large  pad  of  fat 
in  the  olecranon  depression  of  the  os  humeri,  and  in  front  by  another 
mass  in  the  coronoid  depression.  A  small  circular  ridge  of  fat  also 
projects  into  the  joint  around  the  head  of  the  radius,  and  there  is 
another  at  the  internal  margin  of  the  olecranon.  The  object  of  these 
masses  seems  to  be  to  fill  up  the  partial  vacancies  which  exist  between 
the  articular  faces  of  the  bones,  and  they  are  all  so  directed  by  their 
attachment  to  the  capsular  ligament,  as  to  be  preserved  from  being 
pinched.  The  synovial  membrane  is  also  reflected  from  the  capsular 
ligament  to  the  articular  faces  of  the  bones,  so  as  to  line  the  sigmoid 
depressions  on  the  os  humeri,  and  to  include  the  neck  of  the  radius. 

The  head  of  the  radius  is  completely  invested  with  cartilage.  The 
greater  sigmoid  cavity  of  the  ulna  has  its  articular  cartilage  separated 
transversely  into  two  portions,  by  a  small  layer  of  fat  traversing  its 
bottom.  The  cartilage  elsewhere  is  uniformly  spread  over  the  articular 
surfaces  of  the  bones. 

The  Interosseal  Ligament  (membrana  interossea). — It  fills  up  the 
space  between  the  two  bones  of  the  fore  arm  almost  entirely  by  com- 
mencing just  below  the  tubercle  of  the  radius  and  ending  near  the  wrist. 
It  consists  in  oblique  parallel  fibres,  which  pass  from  the  ulnar  edge  of  the 
radius  downwards  to  the  radial  edge  of  the  ulna.  It  is  thin  but  ex- 
tremely strong,  being  covered  in  front  by  the  flexor  muscles ;  and 
behind  by  the  extensors ;  and,  as  M.  Boyer  observes,  seems  to  be  in- 
tended rather  to  afford  origin  to  muscles  than  to  unite  the  bones.  Its 
superior  half  is  thinner  above,  and  a  large  opening  exists  there  for  the 
passing  of  the  interosseal  vessels  to  the  back  of  the  fore  arm.  Its 
inferior  part  is  thick,  where  openings  also  exist,  but  small,  for  the 
passing  of  the  anterior  interosseal  vessels.  There  are  some  other 
smaller  perforations  in  this  ligament,  but  of  less  note  than  the  pre- 


ARTICULATIONS  OF  THE  UPPER  EXTREMITIES.  293 

ceding,  also  for  vessels.     On  its  posterior  face  there  are  one  or  two 
bands,  the  fibres  of  which  decussate  the  other  fibres. 

Besides  the  interosseal  ligamen-t,  there  is  one  called  Round  (lig. 
feres),  situated  obliquely  between  the  two  bones  at  the  upper  part  of 
the  interval  which  separates  them.  It  arises  from  the  base  of  the  co- 
ronoid  process,  just  below  the  insertion  of  the  brachialis  internus,  and 
descending  obliquely  outwards  is  inserted  into  the  radius  below  its 
tubercle.  Its  object  is  to  bind  the  bones  together  at  a  point  which  is 
weakened  by  the  deficiency  of  the  interosseal  ligament.  This  defi- 
ciency is  much  larger  than  the  simple  passing  of  the  vessels  requires, 
for  it  also  allows  the  tubercle  of  the  radius  to  rotate  freely  backwards, 
a  motion  which  would  have  been  checked  by  the  presence  there  of  the 
interosseal  ligament.  The  round  ligament  acts  also  as  a  check  upon 
the  undue  supination  of  the  hand.  It  is  frequently  defective  or  absent. 

Of  the  Articulations  of  the  Wrist. 

Several  articular  cavities  present  themselves  at  this  point.  One  is 
between  the  lower  part  of  the  ulna  and  of  the  radius;  another  between 
the  carpal  bones  and  those  of  the  fore  arm,  and  a  third  between  the 
two  rows  of  carpal  bones.  One  general  capsule  invests  these  parts. 

1.  The  Lower  Radio- Ulnar  Articulation  is  surrounded  by  a  portion 
of  the  fibres  belonging  to  the  general  capsular  ligament  of  the  wrist ; 
their  attachment,  however,  is  so  loose  that  they  allow  the  bones  to 
rotate  freely  upon  each  other,  besides  which  they  are  not  so  abundant 
as  in  other  places.     When  this  joint  is  cut  open  it  will  be  seen  that 
the  head  of  the  ulna  is  covered  with  cartilage;  also  that  the  cartilage 
which  covers  the  carpal  articular  face  of  the  radius  projects  between 
the  ulna  and  the  os  cuneiforme,  and  covers  the  sigmoid  cavity  of  the 
radius ;  so  that  a  cavity  for  receiving  the  convex  head  of  the  ulna  is 
formed  by  the  cartilage   of  the  radius.     The  margins  of  the   above 
projecting  point  of  the  radial  cartilage  are  fibrous,  which  has  induced 
the  French  anatomists  to  speak  of  it  under  the  name  of  triangular 
ligament.     It  is,  in  fact,  an  inter-articular  fibro-cartilage,  and  is  said 
to  be  occasionally  detached  from  the  radius,  but  I  have  not  seen  it  in 
that  state ;  its  centre  is  sometimes  found  perforated,  so  that  a  commu- 
nication  exists   between  this  joint   and   the   next   of  the  wrist.     Its 
margins  adhere  very  closely  to  the  capsular  ligament,  and  its  point  is 
fixed  into  the  depression  which  separates  the  styloid  process  of  the 
ulna  from  its  head.     The  synovial  membrane  which  lines  this  cavity  is 
unusually  loose,  both  before  and  behind,  in  consequence  of  the  great 
motion  of  the  bones ;  it  is  also  very  loose  above.     This  joint  is  called 
the  Sacciform,  from  its  looseness. 

2.  Of  the  Radio-Carpal  Articulation. — The  radius  above,  and  the 
scaphoides,  lunare,  and  cuneiforme  below,  form  the  basis  of  this  articu- 
lation.    An  oblong  semi-elliptical  depression  in  the  radius,  the  ulnar 
extremity  of  which  is  extended  by  the  above  cartilage  of  the  radius, 
receives  the  convexity  of  the  bones  of  the  wrist.     The  scaphoides  and 
the  lunare  come  in  contact  with  the  radius,  while  the  cuneiforme  rests 


294 


SKELETON. 


against  the  projecting  cartilage.  There  is  a  slight  elevation  of  the 
radial  cartilage  opposite  to  the  interstice  between  the  first  two  bones. 
The  articular  cavity  of  the  radius  is  filled  by  a  corresponding  head,  on 
the  part  of  the  bones  of  the  carpus,  just  enumerated.  Each  of  the« 
latter  bones,  in  a  fresh  state,  is  covered  by  its  appropriate  cartilage. 
The  cartilages  are  connected,  or  rather  continued  into  one  another,  by 
a  narrow  fibro-cartilaginous  substance  placed  at  the  margin  of  the 
interstice  between  the  bones.  This  substance  separates  the  cavity  of 
the  radio-carpal  articulation  from  that  of  the  proper  carpal  articula- 
tion. 

The  Capsular  Ligament  arises,  before  and  behind,  around  the  mar- 
gin of  the  articular  face  of  the  bones  of  the  fore  arm,  from  the  styloid 
process  of  the  radius  to  that  of  the  ulna,  adhering  very  closely  to  the 
margins  of  the  fibro-cartilage  insinuated  between  the  ulna  and  the  cunei- 
forme.  It  is  inserted  below,  into  the  circumference  of  the  head  formed 
by  the  scaphoides,  lunare,  and  cuneiforme,  though  many  of  its  fibres  may 
be  traced  to  the  bones  of  the  second  row.  It  is  a  loose  and  thin  mem- 
brane, the  fibrous  fasciculi  of  which  leave  interstices  at  several  points 
between  them,  through  which  the  synovial  membrane  may  be  seen. 
The  capsular  ligament  is  strengthened  at  particular  places  by  addi- 
tional fasciculi  of  fibres  having  appropriate  names  and  being  funicular 

Fig.  90.  ' 


An  anterior  view  of  the  Ligaments  of  the  Wrist,  on  the  left  side.  1.  The  lower  part  of  the  interos- 
seQus  ligament.  2.  The  radio-xilnar  ligament.  3.  The  portion  of  the  capsular  ligament  known  as  the 
anterior  ligament.  4.  The  external  lateral  ligament.  5.  The  internal  lateral  ligament.  6.  The  cap- 
sular ligament  of  the  carpal  bones.  7.  The  pisiform  bone.  8.  The  ligaments  connecting  the  second 
row  of  the  carpus  with  the  metacarpus.  9.  The  capsular  ligament  of  the  carpo- metacarpal  joint  of 
the  thumb.  10.  The  capsular  ligament  of  the  metacarpo-phalangial  joint  of  the  thumb.  11.  The  ex- 
ternal lateral  ligament  of  the  same  joint.  12.  The  capsular  ligament  of  the  metacarpo-phalangial 
articulation  of  the  index  finger.  13,13.  Lateral  ligaments  of  similar  articulations.  14.  The  inferior 
palmar  ligaments.  15.  The  phalangial  joint  of  the  thumb,  with  its  capsular  and  lateral  ligaments. 
16,  16.  The  same  of  the  fore  finger.  The  capsular  ligaments  have  been  removed  in  the  other  fingers. 


ARTICULATIONS  OF  THE  UPPER  EXTREMITIES.  295 

in  shape.  For  example,  the  Internal  lateral  ligament  arises  from  the 
styloid  process  of  the  ulna,  and  is  inserted  into  the  cuneiforme,  some  of 
its  fibres  being  extended  to  the  anterior  annular  ligament,  and  to  the 
pisiforme.  The  External  lateral  ligament  arises  from  the  styloid 
process  of  the  radius,  and  is  inserted  into  the  radial  end  of  the  scapho- 
ides,  some  of  its  fibres  being  continued  on  to  the  trapezium,  and  to 
the  anterior  annular  ligament.  The  anterior  ligament  arises  from  the 
vicinity  of  the  styloid  process  of  the  radius,  and  passing  obliquely 
downwards  and  inwards,  is  inserted  into  the  anterior  face  of  the 
scaphoides,  lunare,  and  cuneiforme.  Its  fasciculi  are  not  very  evident  or 
well  marked  behind.  The  posterior  ligament  is  not  so  broad  as  the 
last,  and  is  more  distinct.  It  also  arises  from  the  radius,  by  and  near 
its  styloid  process,  and  descending  obliquely  inwards,  is  inserted  into 
the  lunare  and  cuneiforme.  The  last  two  ligaments  have  no  connection 
with  the  ulna ;  the  rotation  of  the  fore  arm  is,  therefore,  unimpeded  by 
them.1  The  fibres  of  this  capsular  ligament  are  best  seen  from  the 
surface  attached  to  the  synovial  membrane,  and  are  identified  with  the 
funicular  ligaments,  excepting  the  internal. 

The  synovial  membrane  of  the  radio-carpal  articulation  is  displayed 
over  the  articular  faces  of  the  bones  and  their  intermediate  fibro-carti- 
lage,  and  lines  the  internal  face  of  the  capsular  ligament.  When  the 
joint  is  pressed  upon,  this  membrane  is  protruded,  in  the  form  of  little 
vesicles,  in  the  interstices  between  the  fasciculi  of  the  capsular  ligament. 
A  fold  of  it  containing  a  small  quantity  of  adipose  matter  is  observed 
on  the  back  of  the  cavity  of  the  joint,  passing  from  the  junction  of  the 
scaphoides  and  lunare,  to  the  corresponding  point  of  the  radius ;  it  is 
the  ligamentum  mucosum  of  some  writers. 

3.  Of  the  Articulation  between  the  two  rows  of  the  Carpal  Bones. — 
The  scaphoides,  lunare,  and  cuneiforme  of  the  first  row,  and  all  the 
bones  of  the  second  row,  are  the  foundation  of  this  joint,  the  surfaces 
of  which  have  been  described  already.  These  surfaces  are  covered 
with  cartilage,  each  bone  having  its  appropriate  cartilage,  which  is 
continued  on  its  side  where  the  bone  touches  the  adjacent  one.  The 
joint  is  furnished  with  a  capsular  ligament  and  a  synovial  membrane. 

The  Capsular  Ligament  surrounds  the  articulation,  passing  on  every 
side  from  the  upper  to  the  lower  row,  and  adhering  strongly  to  the  bones. 
It  is  in  a  great  degree  a  continuation  -of  the  capsule  of  the  radio-carpal 
joint,  and  has,  at  the  same  points,  an  increase  of  thickness  by  funicular 
ligaments,  called  after  the  same  names.  The  internal  lateral  ligament 
is  attached  by  one  end  of  the  cuneiforme,  and  by  the  other  to  the  side  of 
the  unciforme.  The  external  lateral  ligament  arises  from  the  ex- 
tremity of  the  scaphoides,  and  is  inserted  into  the  side  of  the  trapezium. 
The  posterior  and  anterior  ligaments  have  the  course  of  their  fibres 
more  distinctly  seen  on  the  side  of  the  synovial  membrane.  The  first 
consists  in  many  fibres  arising  from  the  bones  of  the  first  row  and 
going  to  the  second  row;  its  fibres  are  shorter  and  more  compact. 

1  The  ligamentous  character  of  these  several  fasciculi  is  best  seen  on  the  surface  next  the 
cavity  of  the  joint. 


296  SKELETON. 

The  anterior  arises  and  is  inserted  after  the  same  way,  some  of  them 
terminating  in  the  anterior  ligaments  of  the  hand. 

The  Synovial  Membrane  is  not  only  extended  over  the  opposed  sur- 
faces of  the  two  carpal  rows,  but  also  is  reflected  upon  the  lateral  faces 
of  the  bones  belonging  to  each  row.  It  therefore  sends  processes,  two 
of  which  are  found  above  ;  one  between  the  scaphoides  and  the  lunare, 
and  the  other  between  the  lunare  and  cuneiforme.  These  processes  are 
arrested  at  their  upper  extremities  by  the  fibre-cartilaginous  matter 

Fig.  91. 


A  diagram  showing  the  arrangement  of  the  five  Synovial  Membranes  of  the  Wrist  Joint.  1.  The 
sacciform  membrane.  2.  The  joint  between  the  first  row  of  carpal  bones  and  those  of  the  fore  arm. 
3,  3.  The  synovial  membrane  between  the  two  rows  of  bones.  4.  The  joint  between  the  pisiform  and 
cuneiform  bone.  5.  The  synovial  membrane  at  the  metacarpal  joint  of  the  thumb.  6.  The  radius. 
7.  The  ulna.  8.  The  inter-articular  cartilage,  or  triangular  ligament.  9.  The  metacarpal  bone  of 
the  thumb.  10,  10.  Those  of  the  fingers.  The  capital  letters  indicate  the  separate  bones  of  the  carpus : 
thus,  S.  Scaphoides — L.  Lunare,  &c.  &c. 

between  the  bones,  which  was  spoken  of  in  the  radio-carpal  articulation. 
It  also  sends  three  processes  downwards,  one  between  the  trapezium 
and  the  trapezoides,  another  between  the  latter  and  the  magnum,  and 
the  third  between  the  magnum  and  the  unciforme.  Of  those  latter  pro- 
cesses, two  or  three  communicate  with,  or  are  continuous  with  the 
synovial  membrane,  between  the  carpal  and  the  metacarpal  bones  of  the 
fingers.1  The  connections  and  reflections  of  this  membrane  are  of  the 
greatest  importance,  as  they  form  a  communication  from  the  top  of  the 
wrist  to  the  base  of  the  metacarpal  bones  ;  not  only  covering  .the  articular 
surfaces,  but  being  prolonged  in  some  instances  beyond  them,  as  on  the 
back  of  the  os  magnum,  where  it  answers  as  a  periosteum. 

In  addition  to  the  articulation  just  described,  between  the  two  rows 
of  carpal  bones,  the  individual  bones  of  each  row  have  particular  fast- 
enings of  funicular  ligamentous  fibres,  which  run  transversely  from 
the  margin  of  one  bone  to  the  margin  of  the  next.  These  fibres,  from 
their  position,  are  called  dorsal  and  palmar  ligaments.  The  upper 
row  has  one  dorsal  ligament  between  the  scaphoid  and  lunar,  and  an- 
other between  the  latter  and  the  cuneiforme ;  it  has  in  the  same  way 

1  Bichat,  Anat.  Descr. 


ARTICULATIONS  OF  THE  UPPER  EXTREMITIES.  297 

two  palmar  ligaments  on  its  front  surface.  The  lower  row  has,  after 
the  same  plan,  three  dorsal  and  three  palmar  ligaments  between  its 
bones.  These  several  ligaments  are  best  seen  on  the  side  of  the  sy- 
novial  membrane,  as  externally  their  fibres  are  very  much  mixed  with 
those  of  the  capsular  ligament.  It  is  obvious  that  they  are  highly 
useful  in  preventing  the  bones  from  sliding  laterally  on  each  other, 
except  to  a  small  extent. 

The  Pisiform  Bone  has  an  articulation  with  the  cuneiforme  com- 
pletely distinct  from  any  other.  The  articular  faces  of  this  joint  are 
covered  with  cartilage  and  invested  by  a  synovial  membrane  and  a 
capsular  ligament,  which  allow,  from  their  looseness,  considerable 
motion.  The  capsule,  though  generally  thin,  is  strengthened  by  funi- 
cular accessory  fibres,  which  are  well  marked  below.  These  fibres 
arising  from  the  inferior  extremity  of  the  pisiform,  some  of  them  are 
attached  to  the  extremity  of  the  unciform  process  of  the  os  unciforme, 
and  others  to  the  base  of  the  fifth  metacarpal  bone.  The  insertion  of 
the  tendon  of  the  flexor  carpi  ulnaris  answers  as  a  ligament  to  this 
bone  above,  and  as  there  is  a  very  strong  fasciculus  of  ligament,  pass- 
ing from  the  pisiforme  to  the  end  of  the  unciform  process,  by  that 
means  the  action  of  the  flexor  ulnaris  is  conveyed  to  it,  and  the  pisi- 
form thereby  is  prevented  from  being  pulled  out  of  its  place.  The 
pisiform  bone  acts,  indeed,  as  a  sesamoid  bone  or  patella  in  the  course 
of  the  insertion  of  the  tendon  of  the  flexor  ulnaris.  The  pisiform  has 
but  little  motion  from  above  downwards,  and  a  good  deal  laterally. 

Of  the  Carpo-Metacarpal  Articulations. 

The  bony  articular  surfaces,  here,  as  well  as  all  the  others  of  the 
hand,  have  been  sufficiently  described  and  are  in  the  recent  state 
covered  with  cartilage.  It  will,  therefore,  be  unnecessary  to  renew 
the  observations  on  these  subjects. 

The  first  of  these  articulations,  or  that  of  the  metacarpal  bone  of 
the  thumb,  with  the  trapezium,  is  much  more  movable  than  any  of  the 
others,  and  presents  some  peculiarities.  It  is  entirely  distinct  from 
the  others,  slightly  removed  from  the  next,  and  is  surrounded  by  a  cap- 
sule which  is  attached  by  its  ends  to  the  articular  margins  of  the  bones. 
This  capsule  is  strengthened  by  additional  or  ascititious  fibres,  which 
are  particularly  strong  and  abundant,  posteriorly  and  externally.  The 
synovial  membrane  is  displayed,  as  usual,  on  the  internal  face  of  the 
capsule,  and  over  the  articular  faces. 

The  other  four  metacarpal  bones  are  articulated  as  follows :  The 
second  one  is  joined  to  the  trapezoides,  trapezium,  and  magnum  ;  the 
third  unites  to  the  magnum  alone ;  the  fourth  to  the  unciform,  with  a 
small  portion  of  the  magnum,  and  the  fifth  to  the  unciform.  The 
ligaments  are  placed  before  and  behind,  and  may  also  be  termed  dorsal 
and  palmar. 

The  dorsal  ligaments  descend  from  the  carpal  to  the  metacarpal 
bones.  The  second  metacarpal  bone  receives  two  ligaments,  one  from 
the  trapezium,  and  another  from  the  trapezoides ;  the  third  receives 
one  from  the  magnum ;  the  fourth  receives  two,  one  from  the  magnum. 


298  SKELETON. 

and  the  other  from  the  unciform ;  the  fifth  receives  one  from  the  unci- 
forin.  Transverse  funicular  fibres  pass  between  these  dorsal  ligaments 
to  connect  the  bases  of  the  metacarpal  bones. 

The  palmar  ligaments  are  arranged  on  a  plan  corresponding  with 
that  of  the  dorsal;  but,  from  the  length  of  their  superficial  fibres,  are 
not  so  distinct  from  each  other.  Transverse  fibres  pass  also  between 
the  metacarpal  bones  of  the  fingers  at  their  base,  and  form  interosseous 
ligaments  which  keep  them  together.  A  very  strong  ligament  of  this 
kind  goes  from  the  metacarpal  bone  of  the  fore  finger  to  that  of  the 
thumb. 

The  articulations  thus  formed  and  held  together,  are  covered  by  two 
synovial  membranes,  being  processes  from  that  between  the  two  rows 
of  carpal  bones.  One  of  these  processes,  sent  down  between  the  trape- 
zoides  and  the  magnum,  displays  itself  over  the  inferior  surface  of 
these  bones  and  the  head  of  the  metacarpal  bone  of  the  fore  and  of 
the  middle  finger.  The  second  process,  which  is  sent  down  between 
the  magnum  and  the  unciform,  is  reflected  over  the  last  two  carpo- 
metacarpal  articulations.  These  processes  have  a  septum  between 
them,  at  the  ulnar  side  of  the  base  of  the  third  metacarpal  bone,  and 
do  not  communicate  with  each  other,  except  through  the  proper  carpal 
articulation.  The  specification  of  this  arrangement  is  overlooked  by 
anatomists  generally. 

The  Inferior  Palmar  Ligaments  are  three  in  number,  and  are  be- 
tween the  lower  ends  of  the  metacarpal  bones  of  the  fingers :  each  one 
consists  in  a  transverse  fasciculus,  placed  between  the  flexor  tendons 
and  the  interosseous  muscles,  and  on  a  level  with  the  anterior  part  of 
the  first  joint  of  the  fingers.  Their  more  superficial  fibres  may  be 
traced  across  the  bones,  and  are  somewhat  blended  with  the  capsular 
ligaments ;  the  more  deep-seated  are  short,  and  pass  from  one  bone  to 
the  other. 


Of  the  Metacarpo-Phalangial  Articulations. 

These  are  formed  by  the  lower  ends  of  the  metacarpal  bones,  and 
the  upper  ends  of  the  first  phalanges.  The  funicular  instead  of  the 
capsular  ligament  prevails.  Each  one  presents  an  anterior  ligament, 
two  lateral  ones,  and  a  synovial  membrane. 

The  Anterior  Ligament1  is  a  flat  fibrous  semicircle,  on  the  front  of 
the  articulation,  and  of  considerable  thickness.  It  goes  transversely, 
and  has  its  two  extremities  attached  to  the  ridge  on  either  side  of  the 
articular  margin  of  the  metacarpal  bone.  Its  inferior  margin  descends 
a  little,  and  comes  in  contact  with  the  synovial  membrane.  In  front, 
many  of  its  fibres  are  obtained  from  the  fibro-cartilaginous  sheath  of 
the  flexor  tendons,  so  that  it  may  be  considered  as  made  by  two  planes 
— the  palmar  one  facing  towards  the  tendons,  and  forming  the  trochlea, 
in  which  they  play,  and  the  other  being  next  to  the  joint,  and  con- 
tinued to  the  lateral  ligaments.  The  thickness  of  the  anterior  liga- 
ment, besides  communicating  great  strength  to  the  joint,  is  useful  in 

1  Bichat,  loc.  cit.v 


ARTICULATIONS  OF  THE  LOWER  EXTREMITIES.  299 

removing  the  tendons  from  the  axis  of  the  phalanges,  and  thereby  giv- 
ing increased  power  and  delicacy  of  motion  to  the  muscles.  Bichat 
considers  himself  to  have  first  indicated  particularly  this  structure, 
which  he  thought  was  intended  to  protect  the  articulation  from  the 
impression  of  the  tendon :  to  which  may  be  added,  in  the  firm  grasp- 
ing of  bodies,  and  to  make  the  movements  of  the  joint  more  delicate. 
On  the  sides  of  this  ligament  belonging  to  the  thumb,  and  in  its  thick- 
ness, are  developed  the  sesamoid  bones. 

The  lateral  ligaments  are  situated  one  on  each  side.  They  arise  at 
the  pits  or  the  sides  of  the  metacarpal  bone  behind  the  former,  and  in 
connection  with  it,  and,  descending  obliquely  forwards,  are  fixed  into 
the  sides  of  the  base  of  the  first  phalanx.  They  are  round,  distinct, 
and  strong,  and  are  formed  from  numerous  parallel  fibres. 

The  Synovial  Membrane  lines  this  articulation,  being  displayed  over 
its  lateral  and  anterior  ligaments,  and  on  the  articular  faces  of  the 
bones.  It  is  reflected  on  the  metacarpal  bone,  some  little  distance 
above  the  margin  of  its  cartilage  in  front,  whereby  the  cavity  is  en- 
larged, and  the  flexion  of  the  fingers  is  favored.  It  is  in  contact, 
behind,  with  the  tendon  of  the  extensor  muscle,  which  there  supplies 
the  place  of  capsular  ligament. 

Of  the  Phalangial  Articulations. 

There  are  two  of  these  to  each  finger,  and  one  only  to  the  thumb. 
They  are  provided  with  an  anterior  ligament,  a  lateral  ligament  on 
each  side,  and  a  synovial  membrane. 

The  anterior  Ligament  corresponds  so  exactly  with  what  has  been 
said  in  the  preceding  article  on  the  same  structure,  that,  with  the  ex- 
ception of  its  being  smaller,  the  description  already  given  will  suffice. 
It  seems  to  answer  in  every  respect  the  same  objects. 

The  Lateral  Ligaments,  also,  arising  from  the  sides  of  the  phalanx 
above,  run  downwards  and  somewhat  forwards  to  be  inserted  into  the 
upper  part  of  the  sides  and  the  base  of  the  phalanx  below. 

The  Synovial  Membrane  has  reflections  corresponding  with  those  of 
the  preceding  articulations,  with  the  addition  that  it  covers  more  of 
the  anterior  inferior  face  of  the  first  and  second  phalanges.  Thus,  by 
cutting  through  the  anterior  ligament,  longitudinally,  and  turning  it 
aside,  it  will  be  seen  that  the  cavity  of  the  second  and  third  joints 
of  the  finger  is,  by  this  reflection  of  the  synovial  membrane,  extended 
upwards  between  the  phalanx  and  the  flexor  tendons,  nearly  one-third 
of  the  whole  length  of  the  phalanx,1  a  circumstance  worth  attending 
to  in  the  accidents  of  the  part.  The  synovial  membrane  from  the  de- 
ficiency of  capsular  ligament  behind  is  also  in  contact  there  with  the 
extensor  tendon,  as  the  latter  supplies  the  place  of  ligament.  Hence 
all  the  joints  of  the  fingers  are  very  near  the  surface  upon  their  pos- 
terior semi-circumference  and  easily  laid  open  by  accident. 

1  Bichat,  loc.  cit. 


300  SKELETON. 

CHAPTER  X. 

OF  THE  ARTICULATIONS  OF  THE  LOWER  EXTREMITIES. 
Of  the  Ilio-Femoralj  or  Hip  Articulation. 

THE  basis  of  this  articulation  is  laid  by  the  head  of  the  os  femoris 
being  received  into  the  acetabulum.  Both  surfaces  are  covered  by 
thick  cartilage  :  in  the  former  it  is  interrupted,  however,  by  the  depres- 
sion near  the  centre,  and  becomes  very  thin  near  the  margin ;  and  in 
the  latter,  the  cartilage  is  deficient  in  the  whole  extent  of  the  rough 
surface  at  its  lower  part.  A  cotyloid  ligament,  a  fibrous  capsule,  the 
round  or  inter-articular  ligament,  and  a  synovial  membrane,  are,  more- 
over, concerned  in  this  joint. 

The  Cotyloid  Ligament  (lig.  cotyloideum)  is  a  fibrous  prismatic 
ring  which  tips  the  margin  of  the  acetabulum,  and  thereby  increases 
its  depth  ;  it  can  only  be  seen  by  cutting  open  the  capsule.  Its  thick- 
ness is  unequal,  being  considerable  on  the  anterior  third  of  the  circum- 
ference of  the  acetabulum,  where  it  assists  in  converting  the  notch  into 
a  foramen,  but  not  so  much  so  elsewhere.  Just  below  the  anterior 
inferior  spinous  process,  the  acetabular  head  of  the  rectus  femoris 
sends  some  tendinous  fibres  to  it.  Its  base  is  broader  than  its  margin, 
and  is  marked  off  from  the  articular  cartilage  by  a  crevice,  or  narrow 
groove,  between  them.  Its  acetabular  side  is  covered  by  the  synovial 
membrane  :  the  other  side  has  the  capsular  ligament  adhering  to  it, 
and  the  third  side  adheres  to  the  bone.  Where  it  subtends  the  notch  of 

Fig.  92. 


A  lateral  view  of  the  ligaments  of  the  Hip  Joint  and  Pelvis.  Right  side.  1.  The  posterior  sacro- 
iliac  ligament  of  the  pelvis.  2.  The  greater  sacro-sciatic  ligament.  3.  The  lesser  sacro-sciatic 
ligament.  4.  The  greater  sacro-sciatic  notch.  5.  The  lesser  sacro-sciatic  notch.  6.  The  cotyloid 
ligament  around  the  acetabulum.  7.  The  ligamentum  teres.  8.  The  line  of  attachment  of  the  cap- 
sular ligament  of  the  hip  joint,  posteriorly.  The  ligament  has  been  removed,  in  order  to  show  the  joint, 
9.  The  obturator  ligament. 


ARTICULATIONS  OF  THE  LOWER  EXTREMITIES.  301 

the  acetabulum,  the  cotyloid  ligament  is  augmented  by  additional  liga- 
mentous  fibres,  placed  beneath  it,  and  going  from  the  upper  to  the 
lower  end  of  the  notch  :  these  fibres  consist  of  two  planes,  one  internal 
and  the  other  external,  partly  crossing  each  other,  and  adhering 
closely  to  the  cotyloid  ligament. 

The  Inter-Articular,  or  Round  Ligament  (lig.  teres)  is  a  true  liga- 
mentous  band,  which  is  attached  at  the  one  end  to  the  pit  on  the  head 
of  the  os  femoris,  and  afterwards,  by  a  slight  dissection,  is  easily 
separated  into  two  fasciculi.  Of  these,  the  lower  one  may  be  traced 
to  the  inferior  end  of  the  cotyloid  notch,  where,  winding  around  the 
prominence  of  bone,  it  begins  to  adhere  to  the  ischium,  and  continues 
to  do  so  from  that  point  along  the  anterior  face  of  the  ischium,  just  be- 
low the  acetabulum,  to  a  point  between  the  latter  and  the  upper  anterior 
part  of  the  tuber.  The  other  portion  is  directed  towards  the  superior 
end  of  the  notch,  and  is  attached  there  by  two  extremities,  one  near 
the  margin  of  the  acetabulum,  and  the  other  three  or  four  lines  from 
it  within.1  The  fibres  of  the  round  ligament  are  somewhat  intermixed 
also  with  those  of  the  cotyloid  ligament  subtending  the  notch. 

The  Capsular  Ligament  (capsula  fibrosa)  is  the  strongest  in  the 
body,  and  represents  a  conoidal  sac,  open  at  both  extremities,  by 
which  it  adheres  to  the  bones.  It  is  fixed  by  its  base  to  the  circum- 
ference of  the  acetabulum,  beyond  the  cotyloid  ligament,  and  into  this 
ligament  itself,  where  the  latter  subtends  the  notch.  It  embraces  that 
part  of  the  head  of  the  os  femoris  which  projects  above  the  margin  of 
the  acetabulum,  and  descends  along  the  neck  to  its  root.  It  is  longer 
in  front ;  is  fixed  there  to  the  oblique  line  which  runs  between  the  two 
trochanters,  and,  behind,  into  the  root  of  the  neck,  a  little  in  advance 
of  the  posterior  oblique  ridge  for  the  quadratus  femoris  muscle,  and  in 
such  a  manner  as  to  leave  a  small  part,  six  or  eight  lines  broad,  of  the 
neck  of  the  os  femoris,  bare  below  it.  Above,  it  is  fixed  to  the  neck, 
just  below  the  rough  fossa  in  the  trochanter  major;  and  on  the  under 
surface  of  the  neck  it  adheres,  just  above  the  trochanter  minor.  It  is 
strengthened  in  several  places  by  processes  from  the  fascia  lata  femoris, 
which  descend  to  it  between  the  muscles  surrounding  the  hip  joint.3 
Its  thickness  is  considerable,  but  variable. 

In  front,  and  above,  it  is  remarkably  strong;  is  two  or  three  lines 
thick,  where  it  is  augmented  by  a  large  fasciculus  of  fibres  coming  from 
the  anterior  inferior  spinous  process  of  the  ilium  (ligament.  ascititium\ 

1  Antonius  et  Caldani,  Tabula  II. 

2  Scemmering,  De  Corp.  Hum.  Fabrica,  vol.  ii.  p.  61,  1794.    Andrew  Fyfe,  Compendium 
of  Anat.  Philad.  1807,  vol.  i.  p.  179. 

For  an  interesting  account  of  the  connection  of  this  capsule  with  the  fascia  femoris,  see 
Anatomical  Investigations,  by  J.  D.  Godman,  M.  D.,  Philad.  1824.  The  author,  in  following 
the  sheaths  of  the  muscles,  or,  in  other  words,  the  processes  of  the  fascia  lata,  between  the 
muscles  to  the  capsule,  with  great  attention,  has  been  brought  to  the  conclusion  that  the 
capsule  is  formed  entirely  from  them  He  has  presented  the  same  views  in  regard  to  the 
shoulder  joint,  and  others.  Though  not  disposed  to  concur  in  so  general  an  inference  on  the 
source  of  capsular  ligaments,  inasmuch  as  their  peculiar  texture  is  opposed  to  it,  and  many 
other  circumstances  in  their  anatomical  arrangement,  yet  these  connections  of  the  larger 
joints  have  been  traced  with  an  accuracy  of  great  importance  especially  in  relation  to  sup- 
purations. 


302  SKELETON. 

and  descending,  longitudinally,  to  the  anterior  oblique  ridge  of  the  os 
femoris.  The  internal  and  posterior  portions  of  the  capsular  ligament 
are  not  so  thick ;  it  is,  indeed,  very  thin  near  the  posterior  ridge  of 
the  os  femoris,  being  not  more  than  half  a  line,  and  has  a  number  of 
holes  in  it  for  the  passage  of  vessels.  It  is  strengthened,  internally, 
by  some  fibres  coming  from  the  superior  margin  of  the  thyroid  foramen. 

This  capsular  ligament  keeps  the  bones  closely  applied  to  each  other, 
and  is  by  no  means  so  loose  as  the  corresponding  one  of  the  shoulder 
joint.  Its  fibres  are  very  irregular,  generally,  in  their  course,  and  dif- 
ficult to  follow. 

The  strength  of  this  articulation  depends  principally  on  the  muscles 
which  surround  it,  of  which  the  rectus  femoris,  and  the  iliacus  inter- 
nus  and  psoas  magnus  united,  are  in  front;  between  the  latter  two  and 
the  capsule,  is  a  bursa  mucosa.  Within,  are  the  pectineus  and  the 
obturator  externus;  behind,  are  the  quadratus,  the  gemini,  the  obturator 
internus,  and  the  pyriformis;  above  and  behind,  are  the  glutsei. 

The  Synovial  Membrane  is  a  complete  sac,  displayed  over  the  articu- 
lar surfaces  of  the  bones  and  the  internal  face  of  the  capsule.  It  is 
separated  from  the  roughness  at  the  bottom  of  the  acetabulum,  by  the 
existence  there  of  a  pad  of  very  vascular,  fine,  fatty  matter,  from  which, 
according  to  Bichat,  it  may  be  raised  by  blowing  beneath  the  liga- 
ment of  the  notch,  at  the  point  where  the  blood-vessels  enter.  Coming 
from  the  acetabulum,  it  covers  the  articular  face  of  the  cotyloid  ligament, 
and  is  then  reflected  to  the  capsular  ligament,  to  which  it  gives  a  polished 
internal  surface,  and  from  which  it  may  be  dissected.  On  reaching 
the  root  of  the  neck  of  the  os  femoris,  it  forms  small  longitudinal 
duplicatures,  and  is  reflected  upwards  along  the  neck  to  the  head,  being 
separated  from  the  neck  by  periosteum,  or  by  a  fibrous  tissue,  which 
M.  Boyer  considers  a  continuation  of  the  capsular  ligament.  It  covers 
all  the  head,  except  the  point  of  attachment  for  the  round  ligament, 
and  to  the  latter  it  gives  a  sheath,  which,  at  the  other  end,  is  continuous 
with  the  part  of  the  synovial  membrane  covering  the  fatty  matter. 
From  the  latter  circumstance,  arises  a  deceptive  appearance  of  the 
round  ligament  being  inserted  into  the  roughness  in  the  bottom  of  the 
acetabulum.1 

1  I  found,  in  a  first  instance,  Dec.  10,  1838,  the  capsular  ligament  of  this  joint  with  a  large 
opening,  nine  by  eighteen  lines,  in  front,  and  the  synovial  membrane  communicating  through 
it  with  the  bursa  between  the  trochlea  of  the  ilium  and  the  iliacus  internus  muscle.  A 
similar  arrangement  existed  on  both  sides  of  the  body,  everything  else  being  normal.  It 
was  repeated  in  another  subject,  Jan.  2d,  1839,  and  has  been  observed  in  some  instances 
since  in  our  rooms.  Such  a  condition  must,  of  course,  favor,  under  suitable  circumstances, 
the  internal  dislocation  of  the  os  femoris.  I  attended  a  child  a  year  old,  with  this  disloca- 
tion, but  whose  parents  were  ignorant  of  the  period  of  its  occurrence,  and  which  had  been, 
at  any  rate,  for  some  months  previous.  It  appeared  to  me  that  the  accident  might  have  been 
produced  by  some  trivial  fall,  coincident,  possibly,  with  this  peculiarity.  It  had  been  mis- 
taken for  paralysis  by  the  medical  advisers  previously  employed.  The  same  child  had  a 
dislocation  of  the  os  humeri  which  seemed  almost  spontaneous,  and  could  be  reduced  at 
once  whenever  it  occurred,  which  was  frequently. 


ARTICULATIONS  OF  THE  LOWER  EXTREMITIES.  303 

Of  the  Knee  Joint. 

It  is  formed  by  the  os  femoris,  the  tibia,  and  the  patella,  the  parti- 
cular modelling  of  whose  articular  surfaces,  for  the  purpose,  has  been 
described.  These  surfaces  are  all  covered  by  a  lamina  of  cartilage, 
and  are  held  together  by  an  apparatus  which,  for  the  number  of  its 
parts  and  their  arrangement,  makes  this  the  most  composite  joint  in 
the  skeleton. 

The  most  superficial  layer  of  the  knee  joint  is  the  fascia  lata  of  the 
lower  extremity,  which,  in  passing  down  from  the  thigh  to  the  leg,  is 
so  near  the  cavity  of  the  articulation  on  each  side  of  the  tendon  of  the 
patella,  that  it  is  by  Weitbrecht  spoken  of  under  the  term  of  Common. 
Investment  (involucrum  generale}.  It  is  here  not  only  a  continua- 
tion of  the  fascia  femoris,  but  this  fascia  is  increased  and  thickened  by 
an  aponeurosis,  which  springs  from  the  inferior  extremity  of  the  exten- 
sor muscles  on  the  thigh.  The  membrane  thus  formed  covers  both  the 
patella  and  its  ligament,  and  extends  on  each  side  to  the  lateral  liga- 
ments of  the  joint,  to  which  it  adheres;  it  may  be  traced  even  behind 
them,  but  there  it  becomes  indistinct,  loose,  and  blended  with  common 
cellular  and  adipose  membrane.  The  involucrum  adheres  strongly  to 
the  internal  and  external  condyles,  and  to  the  head  of  the  tibia,  from 
one  lateral  ligament  to  the  other;  it  has  oblique  fibres  on  the  patella, 
transverse  ones  on  the  ligament  of  the  latter,  and  longitudinal  ones  on 
each  side.  It  is  in  contact  with  the  synovial  membrane  of  the  joint, 
except  in  the  middle  portion,  where  it  is  separated  from  it  by  the  patella, 
and  its  tendon,  and  some  adipose  matter.  It  may  be  dissected  without 
difficulty  from  the  subjacent  parts,  by  which  the  ligament  of  the  patella, 
and  the  synovial  membrane  are  brought  into  view. 

Fig.  93.  Fig.  94. 


Fig.  93.  An  anterior  view  of  the  Knee  Joint  of  the  right  side. — 1.  The  tendon  of  the  quadriceps 
femoris  muscle.  2.  The  patella.  3.  The  ligament  of  the  patella.  4,  4.  The  synovial  membrane,  after 
the  removal  of  the  involucrura.  5.  The  internal  lateral  ligament.  6.  The  external  ligament.  7.  The 
anterior  ligament  of  the  superior  peroneo-tibial  articulation. 

Fig.  94.  A  posterior  view  of  the  Knee  Joint  of  the  right  side. — 1.  The  ligament  of  Winslow. 
2.  The  tendon  of  the  semi-membranosns  muscle.  3.  Its  insertion,  showing  the  expansion  of  its  fibres 
4.  The  portion  which  passes  beneath  the  internal  lateral  ligament.  5.  The  internal  lateral  ligament. 
6.  The  external  lateral  ligament.  7.  A  fasciculus  of  the  same,  sometimes  called  the  short  external 
lateral  ligament.  8.  The  tendon  of  the  popliteus  muscle  cut  short.  9.  The  posterior  superior  peroneo 

'  '  ligament. 


'B04  SKELETON. 

The  Ligament  of  the  Patella  being  situated  at  the  fore  part  of  the 
articulation,  though  separated  from  the  extensor  muscles  by  the  inter* 
vention  of  the  patella,  is,  nevertheless,  their  tendinous  insertion  into 
the  leg.  It  arises  from  the  whole  inferior  margin  of  the  patella,  and 
is  inserted  into  the  tubercle  of  the  tibia.  It  consists  in  longitudinal, 
closely  compacted  fibres,  of  a  character  entirely  tendinous ;  the  more 
superficial  of  them  give  a  layer  to  the  front  of  the  patella,  and  in  the 
fracture  of  the  latter  sometimes  prevent  a  separation  of  its  fragments. 
In  front,  as  just  mentioned,  it  is  in  contact  with  the  involucrum ; 
behind  is  a  large  pad  of  fat  placed  between  it  and  the  synovial  mem- 
brane of  the  joint ;  and  on  the  same  surface,  but  lower  down,  it  is  in 
contact  with  a  bursa  mucosa  fixed  between  it  and  the  triangular  flatness 
of  the  tibia  above  the  tubercle. 

A  posterior  ligament,  an  internal  and  an  external  lateral  ligament, 
two  crucial  ligaments,  two  semilunar  cartilages,  and  a  synovial  mem- 
brane, compose  the  remaining  apparatus  of  the  joint. 

The  Posterior  Ligament  (lig.  posticum)  is  a  fibrous  expansion  on 
the  back  of  the  knee  joint,  which  may  be  considered  as  the  proper 
capsular  ligament  at  this  point,  and  has  its  fibres  extending  obliquely 
from  the  external  condyle  of  the  os  femoris  to  the  posterior  part  of  the 
head  of  the  tibia.  It  is  frequently  called  the  ligament  of  Winslow,  and 
by  the  French  anatomists  is  considered  as  one  of  the  divisions  of  the 
tendinous  insertion  of  the  semi-membranosus  muscle,  in  consequence  of 
its  close  connection  with  it.  There  are  several  foramina  or  interstices 
in  it  which  permit  a  passage  of  blood-vessels  to  the  fatty  matter  placed 
between  it  and  the  crucial  ligaments,  and  beneath  it  there  are  some 
^ransverse  fibres. 

The  Internal  Lateral  Ligament  (lig.  laterale  internum)  is  a  flat- 
tened fasciculus  of  fibres  placed  at  the  internal  side  of  the  joint.  It 
arises  from  the  tuberosity  on  the  inner  side  of  the  internal  condyle,  and 
descending  vertically  is  slightly  attached  to  the  inner  semilunar  car- 
tilage, and  is  then  inserted  into  the  superior  margin  and  into  the 
internal  face  of  the  head  of  the  tibia  for  two  inches  or  more,  by  in- 
creasing in  breadth  as  it  descends.  On  the  one  side  it  is  in  contact 
with  the  synovial  membrane,  and  on  the  other,  with  the  involucrum  and 
the  tendon  of  the  sartorius  and  the  gracilis.  The  semi-tendinosus  is 
inserted  under  it,  and  it  has  the  shape  of  a  crotchet  just  at  that  point. 

The  External  Lateral  Ligament  (lig.  laterale  externum,  longum), 
placed  on  the  external  side  of  the  joint,  is  nearer  its  posterior  face  than 
the  internal  ligament.  It  arises  from  the  tuberosity  on  the  outer  face 
of  the  external  condyle,  above  and  behind  the  tendinous  origin  of  the 
popliteus  muscle,  and  is  inserted  into  the  external  part  of  the  superior 
extremity  of  the  fibula,  being  covered  in  almost  its  whole  extent  by 
the  tendon  of  the  biceps.  Its  inner  face  is  in  contact  with  the  synovial 
membrane,  and  the  articular  vessels.  Its  rounded  form  and  shining 
appearance  make  it  look  very  much  like  a  tendon.  Behind  it  occa- 
sionally is  a  small  fasciculus,  called  by  some  the  short  external  late- 
ral ligament,  which  passes  from  the  external  condyle  to  the  head  of 
the  tibia. 


ARTICULATIONS  OF  THE  LOWER  EXTREMITIES.  305 

The  Crucial  Ligaments  (lig.  cruciata),  two  in  number,  are  named 
from  their  crossing  one  another  laterally,  and  thereby  forming  a  figure 
resembling  the  letter  X,  or  a  Malta  cross.  They  are  situated  at  the 
posterior  part  of  the  articulation  between  the  posterior  ligament  and 
the  synovial  membrane.  One  of  them  is  called  anterior,  and  the  other 
posterior,  from  their  relative  situations  to  each  other.  The  first  arises 
from  the  internal  face  of  the  external  condyle,  by  a  depression  near 
the  posterior  end  of  the  notch  and  just  at  the  margin  of  the  articular 
surface;  it  descends  forwards,  and  is  inserted  immediately  in  front  of 
the  little  ridge  between  the  articular  faces  of  the  tibia.  The  second 
arises  from  the  bottom  of  the  notch  between  the  condyles,  just  behind 
the  trochlea  for  the  patella,  upon  a  surface  that  may  be  considered  as 
belonging  to  the  internal  condyle ;  it  descends  backwards,  and  is  in- 
serted into  the  rough  surface  behind  the  aforesaid  spine  or  ridge  of  the 
tibia.  The  crucial  ligaments  are  large,  round,  and  composed  of  parallel 
fibres  very  closely  compacted  ;  their  strength  is  very  considerable,  and 
they  serve  not  only  to  limit  the  extension  of  the  leg,  but  also  to  check 
anything  like  rotation  inwards. 

The  Semilunar  Cartilages  (cartilagines  semilunares,  falcatse)  are 
two  in  number;  one  placed  on  either  side  of  the  superior  face  of  the 
tibia,  between  it  and  the  condyle  of  the  os  femoris.  Their  shape  is 
sufficiently  indicated  by  their  names,  and  as  they  are  placed  on  the 
circumference  of  each  articular  surface  of  the  tibia,  leaving  the  middle 
uncovered,  they  increase  considerably  the  depth  of  the  concavities  for 
receiving  the  condyles.  Their  external  circumference  is  thick,  whereas, 
the  internal  is  reduced  by  a  gradual  diminution  of  their  thickness  to  a 
very  thin  edge ;  they  thereby  make  movable  glenoid  cavities,  which  in 
every  position  of  the  leg  are  closely  filled  up  by  the  condyles.  The  in- 
ternal cartilage  is  but  little  more  than  a  semicircle,  and  is  longer  in  its 
antero-posterior  diameter  than  in  its  transverse ;  on  the  other  hand, 
the  external  is  almost  circular,  an  arrangement  by  which  each  is  suited 
to  its  respective  surface.  They  adhere  by  their  greater  circumferences 
to  the  fibrous  matter  surrounding  the  joint,  particularly  the  lateral 
ligaments,  but  not  so  closely  as  to  prevent  their  sliding  backwards  and 
forwards  in  the  flexions  of  the  leg.  The  tendon  of  the  popliteus  ad- 
heres to  the  external,  either  directly  or  by  the  intervention  of  a  small 
synovial  sac. 

The  internal  semilunar  cartilage  is  attached  by  its  fore  extremity  to 
the  anterior  internal  side  of  the  roughness,  in  front  of  the  ridge  called 
spinous  process,  on  the  top  of  the  tibia;  and  by  the  hind  extremity  to 
the  posterior  face  of  the  base  of  the  ridge,  just  in  advance  of  the  pos- 
terior^crucial  ligament.  The  external  cartilage  is  attached  by  its  ante- 
rior end,  also  to  the  roughness  in  front  of  the  ridge;  but  this  attach- 
ment is  considerably  behind  the  corresponding  one  of  the  internal 
cartilage,  and  is  somewhat  blended  with  the  anterior  crucial  ligament: 
the  posterior  end  is  fixed  into  the  depression  on  the  summit  of  the 
ridge  or  spinous  process,  and  is  there  between  the  two  crucial  ligaments. 
The  external  sends  a  flat  slip  outwards  to  be  attached  to  the  head  of 
the  fibula,  and  over  this  slip,  which  is  a  movable  trochlea,  plays  the 
tendon  of  the  popliteus  muscle.  The  anterior  extremities  of  the  two 
VOL.  I.— 20 


806  SKELETON. 

cartilages  are  united  by  a  transverse  ligamentous  fasciculus  a  line  in 
thickness,  which  is  rather  inconstant;  but  when  found,  is  in  front  of 
the  anterior  crucial  ligament.  These  bodies,  though  presenting  an 
appearance  corresponding  with  cartilages,  on  their  surface,  are  never- 
theless formed  principally  from  concentric  ligamentous  fibres;  the 
character  of  which  is  very  evident  at  their  extremities,  and  when  they 
are  lacerated. 

The  Synovial  Membrane  is  thin,  loose,  and  delicate,  and,  as  in  other 
joints,  is  a  perfect  bag,  covering  the  articular  faces  of  the  bones,  and 
reflected  from  the  one  to  the  other.  As  there  is  no  regular  capsular 
ligament  to  the  knee  joint,  the  synovial  membrane  is  very  distinct  on 
each  side  of  the  tendon  of  the  patella,  and  comes  in  contact  there  as 
stated  with  the  fascia  lata,  or  involucrum,  as  it  passes  from  the  thigh 
to  the  leg.  The  synovial  membrane,  after  covering  the  articular  faces 
of  the  tibia,  is  reflected  from  their  margin  upon  the  semilunar  carti- 
lages, so  as  to  invest  their  inferior  and  superior  surfaces;  it  then 
ascends  to  the  condyles  of  the  os  femoris.  It  covers  the  condyles, 
laterally,  as  well  as  on  their  articular  faces,  and  leaves  thereby  half  an 
inch  or  more  of  their  circumference  on  each  side  of  the  trochlea  of  the 
patella,  included  in  the  periphery  of  the  joint.  The  synovial  mem- 
brane, anteriorly,  being  separated  from  the  tendon  of  the  patella,  by 
the  large  pad  of  fat  there,  then  covers  the  posterior  face  of  the  patella, 
and  rising  up  still  farther,  lines  the  posterior  face  of  the  tendons  of 
the  extensor  muscles  for  the  distance  of  three  inches  or  thereabouts. 
The  superior  end  of  this  reflection  is  formed  into  a  small  pouch  com- 
municating freely  with  the  general  cavity,  but  marked  off  from  it  by  a 
partial  and  variable  septum  on  each  side.  Some  anatomists  consider 
the  pouch  as  a  bursa,  but  it  is  so  seldom  seen  entirely  distinct  from 
the  joint,  that  it  answers  better  to  describe  it  as  a  part  only  of  the 
general  reflection.  The  synovial  membrane,  at  the  sides  of  the  joint, 
is  in  contact  with  the  lateral  ligaments.  Behind,  it  is  reflected  on  the 
anterior  surface  of  the  tendinous  origins  of  the  gastrocnemius,  and 
envelops  the  tendon  of  the  popliteus;  it  also  invests  the  crucial  liga- 
ments, but  in  such  a  way  as  to  leave  them  out  of  its  cavity. 

The  collection  of  fat  behind  the  tendon  of  the  patella  forms,  just  be- 
low the  latter,  a  ridge  on  each  side,  protruding  into  the  articulation, 
and  having  a  fringed  summit  formed  by  a  doubling  of  the  synovial 
membrane.  The  external  ridge  is  the  Ligamentum  Alare  Minus  Ex- 
ternum,  and  the  other  the  Ligamentum  Alare  Majus  Internum.  These 
ridges  unite  at  their  lower  extremities,  and  from  their  place  of  union 
proceeds  a  flattened  conical  process  of  the  synovial  membrane,  in  front 
of  the  anterior  crucial  ligament;  the  point  of  this  process  is  at- 
tached to  the  posterior  extremity  of  the  groove,  in  the  middle  of  the 
trochlea  for  the  patella.  This  duplicature  is  the  Mucous  Ligament 
(lig  amentum  mucosum).  There  are  in  fact  four  fringed  doublings  of 
the  synovial  membrane  visible  in  this  region,  two  above,  and  two  below, 
and  corresponding  with  what  are  called  the  glands  of  joints.  The  two 
superior  being  each  on  its  respective  side  of  the  tendon  of  the  patella 
are  narrow  and  superficial,  and  converge  so  as  to  unite  at  their  inferior 
extremities.  The  two  below,  which  are  the  ones  alluded  to  in  the  pre- 


ARTICULATIONS  OF  THE  LOWER  EXTREMITIES.  307 

ceding  description  as  Lig.  alaria,  are  more  horizontal  in  their  course 
and  much  larger,  have  a  more  striking  connection  with  the  liga- 
mentum  mucosum,  and  they  serve  especially  to  fill  up  the  interstice 
between  the  condyles  of  the  os  femoris  and  the  head  of  the  tibia. 

Of  the  Peroneo-Tibial  Articulation. 

The  tibia  and  the  fibula  are  held  together  by  three  places  of  union, 
one  above,  another  below,  and,  thirdly,  the  ligament  which  fills  up 
the  space  between  the  bodies  of  the  bones. 

1.  The  Superior  Articulation,  formed  by  the  upper  extremity  of  the 
fibula  and  the  outer  side  of  the  head  of  the  tibia,  is  entirely  discon- 
nected with  the  cavity  of  the  knee  joint,  and  has  nothing  in  common 
with  its  apparatus,  except  the   external  lateral  ligament,  which  has 
been  described.     The  articular  faces  are  small,  and  covered  with  car- 
tilage ;  an  anterior  and  a  posterior  ligament,  and  a  synovial  membrane, 
hold  the  bones  together  at  this  point. 

The  anterior  ligament  is  attached  by  one  end  to  the  front  of  the 
head  of  the  fibula,  and  proceeding  upwards  and  inwards,  is  inserted  by 
the  other  into  the  contiguous  part  of  the  head  of  the  tibia,  before  the 
articular  facet.  The  fibres  are  separated  into  fasciculi,  leaving  inter- 
stices between  them  for  cellular  substance. 

The  posterior  ligament  is  narrower  than  the  anterior;  but  its  fibres 
are  more  compact,  and,  like  the  anterior,  they  observe  a  transverse 
course ;  being  attached  by  the  one  end  to  the  head  of  the  fibula,  and, 
by  the  other,  to  the  head  of  the  tibia.  The  popliteus  muscle  covers  it. 
This  joint  is  also  strengthened  by  other  ligamentous  fibres,  and  by  the 
insertion  of  the  tendon  of  the  biceps. 

The  synovial  membrane  is  reflected  over  the  articular  faces  and  the 
ligaments  described,  and  has  nothing  of  particular  interest  in  it.  Oc- 
casionally, the  synovial  membrane  of  the  knee  joint  runs  into  it. 

2.  The  Inferior  Articulation,  which  is  formed  between  the  lower  ex- 
tremities of  the  bones,  is  not  incrusted  by  cartilage,  except  to  the 
breadth  of  a  line  at  its  lower  part,  bordering  on  the  ankle  joint. 

The  anterior  ligament  is  broad,  and  covers  the  face  of  the  bones 
which  are  in  apposition.  Attached  by  the  one  side  to  the  front  of  the 
lower  extremity  of  the  fibula,  its  fibres  pass  obliquely  upwards  and 
inwards,  to  be  inserted  into  the  corresponding  part  of  the  tibia.  Seve- 
ral interstices  exist  in  it  for  the  passage  of  vessels,  and  it  is  covered  by 
the  peroneus  tertius.  Its  lower  margin  is  in  contact  with  the  astraga- 
lus, and  forms  a  portion  of  the  ankle  joint. 

The  posterior  ligament,  in  the  arrangement  and  course  of  its  fibres, 
corresponds  with  the  anterior;  being  attached  by  one  side  to  the  pos- 
terior face  of  the  fibula,  and  by  the  other  to  the  corresponding  part  of 
the  tibia.  Like  the  other,  its  fibres  are  longer  near  the  ankle  joint 
than  above.  Its  lower  margin  is  in  contact  with  the  astragalus,  and 
is  connected  with  other  ligaments  coming  from  the  fibula. 

In  the  space  between  the  anterior  and  the  posterior  ligament,  where 
the  bones  touch,  they  are  agglutinated  by  a  short,  strong,  fibrous  tissue, 


308  SKELETON. 

leaving  intervals  occupied  by  adipose  matter.     It  contributes  much  to 
the  solidity  and  immobility  of  this  articulation. 

8.  The  Interosseous  Ligament  (membrana  interossea)  is  analogous 
to  that  in  the  fore  arm,  by  being  a  membrane  stretched  between  the 
two  bones.  It  arises  from  the  ridge  on  the  outer  face  of  the  tibia,  and  is 
attached  to  the  corresponding  ridge  on  the  inner  face  of  the  fibula.  It  is 
broader  above  than  below,  being  at  the  latter  point  ^continuous  with  the 
fibrous  structure  which  agglutinates  the  bones.  Just  below  the  head  of 
the  fibula  is  a  large  hole  for  transmitting  the  anterior  tibial  vessels,  and 
the  origin  of  the  tibialis  posticus  muscle.  It  also  presents,  in  its  de- 
scent, several  smaller  foramina  for  the  passage  of  vessels.  Its  fibres 
are  strong  and  unyielding,  and  run  obliquely  downwards  from  the  tibia 
to  the  fibula.  It  is  covered  in  its  whole  length,  both  before  and  be- 
hind, by  muscles,  and  serves  as  an  origin  to  them  and  as  a  means  of 
attachment  between  the  bones. 

Of  the  Ankle  Joint. 

The  articular  surfaces,  here,  being  covered  by  cartilage  as  in  other 
movable  joints,  are  formed  by  the  astragalus  being  received  into  a 
deep  cavity  made  by  the  tibia  and  the  fibula.  The  capsular  ligament, 
properly  speaking,  does  not  exist  either  on  the  front  or  back  of  the 
joint,  and  is  represented,  there,  by  a  few  scattered,  loose  fibres,  on  the 
periphery  of  the  synovial  membrane.  An  internal  and  an  external 
lateral  ligament,  with  the  synovial  membrane,  constitute  the  whole 
apparatus. 

The  Internal  Lateral  Ligament,  also  called  the  Deltoid  (lig.  del- 
toideum),  arises  from  the  whole  inferior  margin  of  the  malleolus  inter- 
ims, and  with  particular  strength  from  the  depression  which  exists  in  it : 
it  then  descends  and  is  inserted  into  the  internal  face  of  the  astragalus, 
and  into  the  lesser  apophysis  of  the  os  calcis,  which  lies  just  below  it, 
being  also  strongly  attached  at  its  anterior  part  to  the  Internal  Calcaneo- 

Fig.  95.  Fig.  90. 


Fig.  95.  An  internal  view  of  the  Ankle  Joint  of  the  right  side.— 1.  Internal  malleolus.  2,  2.  Part 
of  the  astragalus,  the  rest  being  concealed  by  ligaments  3.  Os  calcis.  4.  Scaphoides  5.  Internal 
cuneiform  bone.  6.  Internal  lateral,  or  deltoid  ligament.  7.  The  synovial  capsule,  covered  by  a  few 
fibres  of  a  capsular  ligament.  8.  Tendo-Achillis. 

Fig.  96.  An  external  view  of  the  Right  Ankle  Joint.— 1.  The  tibia.  2.  The  external  malleolus  of 
the  fibula.  3,  3.  The  astragalus.  4.  The  os  calcis.  5.  Thecuboides.  6,  7,  8.  The  anterior,  middle, 
and  posterior  fasciculi  of  the  external  lateral  ligament.  9.  The  imperfect  capsular  ligament. 


ARTICULATIONS  OP  THE  LOWER  EXTREMITIES.  309 

Scaphoid  Ligament.  This  internal  lateral  ligament  is  broad,  thick, 
quadrilateral,  and  composed  of  fibres  which  descend  obliquely  back- 
wards. The  tendon  of  the  tibialis  posticus  runs  in  a  trochlea  which  is 
formed  on  the  internal  face  of  this  ligament. 

The  External  Lateral  Ligament  (lig.  triquetrum)  consists  in  three 
distinct  fasciculi,  of  which  one  is  anterior,  another  posterior,  and  the 
third  in  the  middle.  The  anterior  arises  from  the  lower  extremity  of 
the  malleolus  externus,  and  running  inwards  and  forwards,  is  inserted 
into  the  outer  face  of  the  astragalus  in  front  of  the  surface  for  the 
fibula.  The  posterior  arises  from  the  depression  in  the  extremity  of 
the  malleolus  externus,  and,  running  inwards  and  backwards,  is  attached 
to  the  point  of  the  astragalus,  at  the  outside  of  the  groove,  for  the 
tendon  of  the  flexor  pollicis  pedis.  The  middle  arises  from  the  pointed 
termination  of  the  malleolus  externus,  and  descending  beneath  the 
tendons  of  the  peronei  muscles,  is  attached  to  the  external  face  of  the 
os  calcis,  below  the  surface  for  the  astragalus.  These  fasciculi  are  com- 
posed of  strong  longitudinal  and  parallel  fibres.  The  posterior  is  larger 
than  either  of  the  others,  and  occasionally  detaches  a  part  which  is 
inserted  into  the  posterior  margin  of  the  articular  face  of  the  tibia. 

The  Synovial  membrane  is  reflected,  as  usual,  over  the  articular  sur- 
faces, and  from  one  bone  to  the  other.  It  sends  up  a  short  process  of 
a  line  in  length  between  the  tibia  and  the  fibula,  it  is  remarkably  loose 
in  front  and  behind,  and  has  on  its  superficial  face  a  considerable  quan- 
tity of  adipose  matter,  which  cannot  be  easily  detached  from  it.  It 
commonly  contains  an  unusual  quantity  of  synovia. 

Of  the  Articulations  of  the  Foot. 

Of  the  Tarsal  Articulations. — 1.  The  Os  Astragalus  is  united  to  the 
Os  Calcis  by  a  double  articular  surface,  which  has  been  described.  The 
ligaments  which  hold  them  together  are  as  follows. 

The  Interosseous  Ligament  is  placed  between  the  two  bones,  so  as  to 
occupy  the  large  oblique  fossa  between  the  double  articular  surface  in 
each.  It  is  a  collection  of  very  strong,  short  fibres,  with  interstices  for 
fatty  matter,  and  which,  arising  from  the  whole  length  of  the  groove 
in  the  astragalus,  descends  to  be  inserted  into  corresponding  points  in 
the  groove  of  the  os  calcis.  Where  the  fossa  is  narrow,  as  it  is  behind,  the 
ligament  is  thin  and  flat,  but  it  augments  considerably  in  front,  where 
there  is  more  room  for  it. 

The  Posterior  Ligament  arises  from  the  posterior  margin  of  the 
astragalus,  and,  descending  obliquely  inwards,  is  inserted  into  the 
adjacent  portion  of  the  os  calcis.  Its  fibres  are  blended  with  those  of 
the  Deltoid  Ligament,  and  on  their  posterior  face  they  form  a  liga- 
inentous  trochlea  for  the  tendon  of  the  flexor  longus  pollicis  pedis. 

This  articulation  is  also  strengthened  by  the  insertions  stated  of  the 
lateral  ligaments  of  the  ankle  joint  into  the  os  calcis. 

The  Synovial  membrane  forms  a  distinct  cavity  on  the  posterior  and 
larger  articular  face  of  the  two  bones,  and  is  in  contact  with  the  fatty 
matter  in  advance  of  the  tendo-Achillis. 


310  SKELETON. 

2.  The  Articulation  of  the  Astragalus  with  the  Scaphoides  is  formed 
by  the  convex  head  on  the  part  of  the  former,  and  by  the  concavity 
on  the  part  of  the  latter.  It  is  covered  above  by  a  thin,  broad  liga- 
ment, with  parallel  and  oblique  fibres,  which,  arising  from  the  superior 
and  internal  face  of  the  astragalus,  are  implanted  into  the  upper  face 
of  the  scaphoides,  some  of  its  fibres  extending  over  to  the  cuneiform 
bones.  It  is  covered  above  by  the  tendons  of  the  extensor  muscles  of 
the  toes,  and  of  the  tibialis  anticus. 

On  the  under  surface  of  the  foot,  this  articulation  is  supported  by 
two  ligaments,  called  the  Calcaneo-Scaphoid  (lig.  pland),  from  their 
origin  and  insertion.  The  Internal  one  arises  from  the  internal  mar- 
gin of  the  lesser  apophysis  of  the  os  calcis,  and  running  obliquely 
forwards  and  inwards,  is  inserted  into  the  under  and  internal  surface 
of  the  os  scaphoides.  It  is  a  very  thick,  flattened  fasciculus,  on  the 
under  surface  of  which  is  formed  the  ligamentous  trochlese,  in  which 
run  the  tendons  of  the  flexor  longuspollicis  and  flexor  longus  digitorum, 
and  which  surface  is  also  in  contact  with  the  tendon  of  the  tibialis 
posticus.  By  subtending  the  head  of  the  astragalus,  the  Internal  Cal- 
caneo-Scaphoid Ligament  contributes  largely  to  keeping  it  in  place,  in 
the  erect  position.  The  External  Calcaneo-Scaphoid  Ligament,  placed 
at  the  outer  margin  of  the  last,  arises  from  the  under  surface  of  the 
greater  apophysis  of  the  os  calcis,  and  running  obliquely  inwards  and 
forwards  is  implanted  into  the  under  external  surface  of  the  scaphoides. 
It  consists  in  two  or  more  short,  strong  fasciculi. 

Fig.  97. 


A  view  of  the  Ligaments  of  the  Sole  of  the  Foot,  left  side.  1.  The  under  surface  of  the  os  calcis.  2.  The 
astrao-alus.  3  The  scaphoides.  4,  5.  The  two  planes  of  fibres  of  the  caleaneo-cuboid  ligament,  b. 
The  calcaneo-scaphoid  ligament.  7.  I  he  plantar  ligaments.  8,  8.  The  ptroneus  longus  tendon.  9,9. 
The  tarso-metatarsal  plantar  ligaments.  10.  I  he  capsular  ligament  of  th  first  joint  of  the  big  toe. 
11.  The  lateral  ligaments  of  the  first  joints  of  the  toes.  12.  The  transverse  ligament,  li.  Lateral 
ligaments  of  the  last  joints  of  the  toes. 


ARTICULATIONS  OF  THE  LOWER  EXTREMITIES.  311 

The  Synovial  Membrane  of  the  articulation  between  the  astragalus 
and  the  scaphoides  covers  the  articular  faces  of  these  bones  and  lines 
the  ligaments  above  and  below.  A  reflection  of  it  also  lines  the  articu- 
lation between  the  os  calcis  and  the  astragalus,  in  front  of  the  rough 
fossa  which  is  occupied  by  their  interosseous  ligament. 

3.  The  Calcaneo-Cuboid  articulation,  formed  by  the  two  bones  indi- 
cated in  the  name,  is  maintained  by  two  ligaments,  one  above,  the 
other  below,  and  by  a  synovial  membrane. 

The  Superior  Calcaneo-Cuboid  Ligament  arises  from  the  upper  an- 
terior surface  of  the  os  calcis,  and  is  inserted  into  the  adjoining  upper 
surface  of  the  cuboides.  It  is  broad,  thin,  and  quadrilateral,  with 
short  parallel  fibres,  and  is  in  contact  above  with  the  peroneus  tertius 
tendon. 

The  Inferior  Calcaneo-Cuboid  Ligament  (lig.  plantare),  placed  on 
the  plantar  surface  of  the  foot,  is  remarkable  for  its  size  and  extent. 
It  consists  of  two  horizontal  planes  of  fibres,  of  which  the  superficial  is 
the  longer.  The  latter  arises  from  the  back  under  surface  of  the  os 
calcis,  and  advancing  forwards,  its  fibres  are  inserted  into  the  summit 
of  the  ridge  which  traverses  the  cuboides  obliquely ;  the  greater  part 
of  them,  however,  go  beyond  this  point,  and,  dividing  into  fasciculi,  are 
inserted  into  the  base  of  the  fourth  and  fifth  metatarsal  bones.  The 
tendon  of  the  peroneus  longus  is  confined  between  these  fasciculi  and 
the,  under  surface  of  the  cuboides.  The  other  plane  of  this  ligament, 
being  more  deeply  seated,  is  also  shorter.  It  arises  from  the  front 
under  surface  of  the  os  calcis,  where  the  tuberosity  exists  at  this  point, 
and,  by  advancing,  is  inserted  entirely  into  the  oblique  ridge  of  the 
cuboides. 

The  Synovial  Membrane  being  reflected  over  the  articular  surfaces 

Fig.  98. 


A  vertical  section  of  the  Ankle  Joint  and  Foot  of  the  right  side.  1.  The  tibia.  2  The  astragalus. 
3  Os  calcis  4  The  scaphoides  5.  I  he  cuneiforme  internum  6  The  metatarsal  bone  of  the  great 
toe  7  I  he  first  phalanx  of  the  great  toe  8  I  he  second  phalanx  of  the  great  toe.  9  the  articular 
cavity  between  the  tibia  and  astragalus,  with  its  articular  adipose  matter.  10  The  synovial  capsule 
between  the  astragalus  and  calcis  11  The  calcaneo-astragalien  interosseous  ligament  12.  The 
synovial  capsule  between  the  astragalus  and  scaphoides  13  The  calcaneo-scaphoid  ligament  14. 
The  calcaneo-cuboid  ligament.  15.  The  synovial  capsule  between  the  scaphoides  and  cuneiforme 
internum.  16  The  synovial  capsule  between  the  cuneiforme  internum  and  the  first  metatarsal  bone. 
17  The  metatarsal-phalangial  articulation  of  the  great  toe,  with  the  sesamoid  bones  below.  18.  The 
phalangial  articulation  of  the  great  toe. 


312  SKELETON.    v 

of  the  bones,  and  lining  the  ligaments,  is  uncovered  at  several  places 
above  where  interstices  exist  between  the  fibres  of  the  superior  liga- 
ment, and  externally  it  is  contiguous  to  the  tendon  of  the  peroneus 
longus. 

4.  The  Scaphoid  and  the  Cuboid  bones  touch  at  the  external  pos- 
terior angle  of  the  cuneiforme  externum,  and  form  there,  occasionally, 
a  distinct  articular  surface  with  a  synovial  membrane.     Besides  this 
mode  of  union,  an  interosseous  ligament  is  introduced  between  them. 
On  the  dorsum  of  the  foot  there  is  a  transverse  ligament  running  from 
one  bone  to  the  other  beneath  the  extensor  tendons,  and  on  the  sole  of 
the  foot  there  is  an  oblique  ligament,  which,  arising  from  the  under 
surface  of  the  scaphoides,  is  inserted  into  the  anterior  internal  margin 
of  the  cuboides. 

The  articular  surfaces  of  the  Cuboides  and  Cuneiforme  Externum, 
which  are  in  contact,  besides  a  distinct  synovial  membrane,  are  secured 
by  transverse  and  oblique  ligamentous  fibres  going  from  the  one  bone 
to  the  other. 

5.  The  Articulation  between  the  scaphoides  and  the  three  cunei- 
form bones  is  secured  by  dorsal  and  plantar  ligaments.     The  dorsal, 
arising  from  the  back  of  the  scaphoides,  is  in  three  fasciculi,  that  go 
respectively  to  the  back  of  each  cuneiform  bone ;  of  them  the  inter- 
nal is  the  strongest,  and  is  particularly  well  marked  on  the  internal 
face  of  the  cuneiforme  internum.     The  plantar  ligaments  are,  also, 
three  in  number,  and  having  a  sort  of  common  base  from  the  under 
surface  of  the  scaphoides  ;  by  being  divided  into  three  fasciculi,  as  the 
above,  are  inserted  into  each  cuneiform  bone.     They  are  not  so  well 
marked  as  the  upper  ones. 

The  cuneiform  bones  are  also  connected  together  above  and  below, 
by  short  transverse  ligaments  going  from  one  bone  to  the  other,  and 
holding  their  lateral  surfaces  in  contact.  Those  below  are  not  so  dis- 
tinct as  the  upper  ones,  and  are  blended  with  the  insertions  of  the 
tibialis  posticus. 

« 

One  synovial  membrane  covers  the  articular  surfaces  of  the  scapho- 
ides and  of  the  cuneiform  bones  which  are  in  contact ;  and  it  extends 
itself  by  digital  processes  between  the  first  and  second,  and  the  second 
and  third  cuneiforms,  so  as  to  line  also  the  articulations  there.  The 
process  between  the  latter  two  is  much  shorter  than  the  process  be- 
tween the  former  two,  which  extends  itself  into  the  tarso-metatarsal 
articulations,  after  the  same  principle  which  is  observable  in  the  hand. 

Of  the  Tarso-Metatarsal  Articulations. 

The  articular  faces  of  the  bones,  here,  having  been  sufficiently  de- 
scribed, it  is  to  be  noted  in  addition,  that  besides  being  covered  with 
cartilage,  they  have  the  apparatus  of  the  movable  articulations  gene- 
rally, in  ligaments  which  hold  them  together,  and  in  synovial  mem- 
branes. The  ligaments  are  above  and  below. 


ARTICULATIONS  OF  THE  LOWER  EXTREMITIES.  313 

1.  The  articulation  of  the  first  metatarsal  bone  with  the  cuneiforme 
internum  is  one-third   of  an  inch   in  advance  of  the  next,  and  com- 
pletely insulated  by  its  synovial  membrane  :  it  is  strongly  secured  by 
ligamentous  fibres  above,  internally  and  below,  which  give  it  almost  a 
complete  capsule. 

2.  The  dorsal  or  upper  ligaments  of  the  remaining  metatarsal  bones 
are  arranged  as  follows.     There  are  three  for  the  second  metatarsal ; 
one  comes  from  the  second  cuneiform,  one  from  the  first,  and  another 
from  the  third  ;    the  latter  two  are  oblique,  and  they  all  converge 
to  be  inserted  into  the  base  of  the  bone  to  which  they  belong.     One 
dorsal  ligament  passes  from  the  third  cuneiform  to  the  base  of  the 
third  metatarsal ;  it  is   sometimes   assisted  by  a  fasciculus   from  the 
cuboides.     From  the  superior  face  of  the  cuboid  bone  a  fasciculus  is 
sent  to  the  base  of  the  fourth  and  fifth  metatarsals. 

The  plantar  or  under  ligaments  are  arranged  on  the  same  plan  with 
the  dorsal.  Not  being  quite  so  strong,  they  are  augmented  by  the 
fibrous  sheaths  of  the  flexor  tendons  which  lie  upon  them. 

The  synovial  membrane,  which  is  reflected  over  the  articular  surfaces 
between  the  second  and  third  metatarsals  and  their  corresponding 
cuneiforms,  is  the  elongation  of  the  digital  process  sent  from  the  sca- 
phoid articulation,  between  the  first  and  second  cuneiforms.  This  pro- 
cess, besides  extending  to  the  aforesaid  tarso- metatarsal  articulations, 
insinuates  itself  to  the  articular  surfaces  on  the  sides  of  the  second 
metatarsal  bone ;  but  a  distinct  synovial  capsule  is  sometimes  formed 
between  the  base  of  the  third  and  fourth  metatarsals. 

One  synovial  membrane  is  reflected  over  the  surfaces,  between  the 
cuboides  and  the  last  two  metatarsals,  and  sends  in  a  process  between 
the  latter.  In  all  these  cases  the  synovial  membranes  line  the  dorsal 
and  plantar  ligaments  of  their  respective  articulations. 

Of  the  Metatarsal  Articulations. 

The  metatarsal  bones,  with  the  exception  of  the  first,  articulate  with 
each  other  by  the  contiguous  faces  of  their  roots,  as  has  just  been  stated, 
along  with  the  manner  of  their  getting,  at  these  points,  a  lining  of 
synovial  membrane.  They  are  farther  fastened  to  each  other  by  short 
transverse  ligamentous  fasciculi,  which  pass  from  the  base  of  one  to 
the  base  of  the  adjoining.  These  fasciculi  exist  both  on  the  upper  and 
under  surface  of  the  bones,  are,  therefore,  denominated  dorsal  and 
plantar  metatarsal  ligaments.  There  is  also  a  description  of  interos- 
seous  ligament  between  the  bases  of  these  bones,  occupying  the  space 
intermediate  to  the  dorsal  and  plantar  ligaments  of  each. 

The  anterior  extremities  of  the  metatarsal  bones  are  not  in  contact ; 
they  are,  however,  fastened  to  each  other  by  a  transverse  or  Anterior 
Plantar  Ligament  on  their  under  surface,  the  fibres  of  which  are  some- 
what blended  with  the  capsular  ligaments  of  the  first  joints  of  the  toes. 


314  SKELETON. 

Of  the  First  Joints  of  the  Toes. 

The  surfaces  of  the  bones  here  being  covered  with  cartilage,  are 
formed  into  an  arthrodial  articulation.  There  is  a  fibrous  capsule  sur- 
rounding the  articular  faces,  and  enclosing  the  synovial  membrane. 
This  capsule  is  considerably  thickened  below,  where  the  flexor  tendons 
pass  over  it ;  above,  it  does  not  exist,  as  the  extensor  tendon  is  there 
lined  by  the  synovial  membrane.  On  each  side  is  a  lateral  ligament, 
but  much  weaker  than  the  corresponding  ligament  of  the  fingers.  In 
the  great  toe  the  external  lateral  ligament  is  frequently  inserted  into 
the  outer  sesamoid  rather  than  into  the  first  phalanx,  and  is  sometimes 
almost  wanting.  In  the  under  part  of  the  capsule  of  the  great  toe,  we 
find  on  each  side  a  sesamoid  bone. 

These  joints  resemble  so  strongly  the  corresponding  joints  of  the 
fingers,  that  a  farther  description  is  unnecessary. 

Of  the  Second  and  Third  Joints  of  the  Toes. 

From  the  shape  of  the  surfaces  of  the  bones  composing  them,  these 
are  simply  ginglymous  articulations.  They  have  their  cartilaginous 
incrustations,  synovial  membrane,  and  capsular  ligament.  The  under 
part  of  the  latter  is  much  thickened,  and  forms  a  trochlea  for  the  flexor 
tendons,  and  above  it  is  defective,  as  the  synovial  membrane  is  in  con- 
tact with  the  extensor  tendon.  On  each  side  is  a  lateral  ligament. 
These  joints  also  resemble  so  strongly  the  corresponding  ones  of  the 
fingers,  that  farther  description  is  unnecessary. 


BOOK  II. 


OF  THE  INTEGUMENTS  OF  THE  BODY. 

THE  integuments  consist  in  Cellular  and  in  Adipose  Substance,  and 
in  the  Dermoid  Covering. 


PART  I. 

Histology  of  Cellular  and  of  Adipose  Substances. 

CHAPTER  I. 
OF  THE  CELLULAR  SUBSTANCE. 

THE  Cellular  Substance  (textus  cellulosus,  mucosus)  also  called 
Areolar  Tissue,  Uniting  Amorphous  Tissue,  Connective  Tissue,  Con- 
junctive Tissue,  is  an  elementary  one,  and  is  more  generally  diffused 
than  any  other  of  the  body,  for  it  seems  to  be  quite  as  indispensable  to 
the  latter  as  the  corpus  mucosum  is  to  vegetables.  It  is  found  abund- 
antly beneath  the  skin ;  between  muscles ;  in  the  interstices  of  mus- 
cles and  of  other  parts;  connecting  membranes  to  one  another;  sur- 
rounding organs;  entering  into  their  composition;  gluing  them  together; 
in  fine,  under  every  variety  of  circumstance  and  of  locality  which  the 
human  organization  admits.  Indispensable  as  it  is  to  the  texture  of 
all  other  parts,  we  find  it,  as  may  be  expected,  preceding  them  in  the 
development  of  the  foetus ;  at  which  period  it  is  in  the  condition  of  a 
fluid  slightly  inspissated. 

It  is  remarkable  for  its  whiteness,  translucency,  and  flexibility. 
When  examined  with  a  microscope,  as  it  winds  around  a  muscle  and 
introduces  itself  between  the  fasciculi  of  its  fibres,  it  will  be  seen  that, 
however  fine  the  latter  may  be,  yet  this  tissue  is  interposed  between 
them  in  thin  laminae.  On  separating  these  fibres,  the  intervening 
laminae  are  resolved  or  drawn  out  into  fine  filaments,  which,  finally, 
break  after  being  stretched  to  a  certain  extent.  The  lamina  which 
surrounds  the  whole  body  of  the  muscle,  and  constitutes  its  sheath,  on 
being  put  upon  the  stretch,  tears  only  after  having  been  attenuated 
into  still  thinner  laminae  and  into  fibres. 


316  INTEGUMENTS. 

If  air  be  blown  into  the  sheath  of  a  muscle,  this  sheath  is  distended 
into  a  multitude  of  cells  of  various  forms  and  sizes,  which  have  no  de- 
termined shape,  and  do  not,  upon  the  expulsion  of  the  air,  return  to  the 
same  shape  upon  a  repetition  of  the  inflation.  Such  cells  communi- 
cate very  freely ;  all  limpid  fluids  pass  with  the  greatest  ease  from  one 
to  the  other,  so  that  from  any  single  point  they  may,  by  the  force  of 
injection,  be  distributed  throughout  the  body;  this  is  manifested  in 
emphysema,  where  from  a  small  wound  in  the  thorax,  air  becomes 
universally  diffused.  Fluids  of  any  kind,  except  they  be  inspissated, 
when  deposited  in  these  cells,  are  subject  to  the  common  laws  of  gravita- 
tion, and  continue  to  descend  successively  from  the  higher  to  the  lower 
cells,  as  in  anasarca.  Blood  traverses  them  very  readily  in  ecchymosis. 

Cellular  tissue  enjoys  a  good  deal  of  elasticity,  for  when  stretched 
it  readily  returns  upon  itself.  When  very  thin,  as  between  the  fibrillse 
of  muscles,  it  is  colorless  or  nearly  so,  and  of  a  gelatinous  or  glue-like 
consistence ;  but  when  its  laminae  are  thicker,  it  is  of  an  opaque  white, 
and  has  a  strength  amounting  almost  to  that  of  ligamentous  matter. 
When  dried  it  becomes  crisp  and  of  a  dark  brown ;  but  may  be  restored 
to  its  color  and  condition  by  soaking  in  water.  It  is  only  very  slightly 
affected  by  the  usual  heat  of  the  culinary  processes  of  roasting  or  boil- 
ing, as  our  dishes  of  meat  daily  prove;  but  may  be  resolved  into  gela- 
tin after  a  protracted  ebullition.  Its  putrefaction  is  slow,  and  cannot 
be  accomplished,  by  maceration,  under  a  considerable  lapse  of  time, 
depending  much,  however,  upon  the  season  of  the  year,  and  other  cir- 
cumstances. 

The  cellular  substance  is  pervaded  by  a  large  number  of  blood-ves- 
sels, the  majority  of  which  do  not,  in  a  natural  state,  convey  obviously 
red  blood ;  but  if  any  portion  of  it  be  exposed  for  a  short  time  to  the 
air,  or  to  any  other  unusual  stimulus,  it  quickly  becomes  suffused  with 
red  blood,  circulating  through  an  infinitude  of  channels.  It  cannot, 
however,  be  conceded,  as  Ruysch  supposes,  that  it  is  formed  exclusively 
of  blood-vessels.  Some  anatomists,  indeed,  as  Haller  and  Prochaska, 
allow  that  though  blood-vessels  ramify  through  it,  yet  they  are  not 
spent  upon  it,  or  do  not  form  a  part  of  its  organization.  The  distinc- 
tion is  rather  too  subtle  to  be  readily  admitted,  and  seems,  moreover, 
to  be  refuted  by  the  continued  exhalation  and  absorption  which  are  going 
on  within.  It  does  not  appear  that  nerves  are  spent  upon  the  cellular 
substance,  though  they  pass  abundantly  through  it,  as  a  blastema,  to 
their  respective  organs. 

It  is  probable  that  the  granulations  upon  which  injured  parts  of  the 
body  depend  for  their  restoration,  arise  from  this  cellular  substance. 
It  abounds  in  lymphatic  trunks  as  they  pass  along  from  different  parts 
of  the  body,  and  has  no  doubt  an  intimate  connection  with  the  absorb- 
ent system,  though  there  are  great  difficulties  in  detecting  the  mode. 
The  late  Professor  Wistar  attended  a  patient  for  compound  fracture  of 
the  leg,  with  a  large  wound,  which  was  subsequently  covered  with  luxu- 
riant granulations.  The  lirnb  was  suddenly  attacked  with  an  cedematous 
swelling,  which  extended  itself  to  the  sore,  and  caused  its  granulations 
to  tumefy,  so  that  they  pitted  upon  pressure  precisely  like  other  parts.1 

!  System  of  Anat.  vol.  i.  p.  388,  2d  edition. 


CELLULAR  SUBSTANCE.  317 

The  most  generally  received  opinion  of  anatomists,1  in  regard  to  the 
arrangement  of  cellular  tissue  is,  that  it  results  from  the  assemblage  of 
a  multitude  of  lamellae,  and  of  fine  soft  filaments,  which  being  variously 
interwoven,  produce  a  series  of  cells  all  communicating  one  with  another, 
but  varying  in  their  shape  and  size :  so  that  the  whole  cellular  sub- 
stance may  be  considered  to  represent  a  single  cavity  subdivided  into 
an  infinitude  of  smaller  ones.  To  this  it  is  objected,2  that  when  this 
tissue  is  accurately  examined,  it  appears  rather  as  a  homogeneous, 
viscid,  and  only  partially  solidified  substance  ;  particularly  in  the  in- 
ferior orders  of  animals,  and  in  the  embryo  state  of  the  more  exalted, 
where  it  has  still  to  admit  the  deposite  or  formation  of  the  several 
organs.  That  the  same  is  manifested  at  any  period  of  life,  for  neither 
with  the  naked  nor  assisted  eye  does  it  assume  any  other  appearance. 
That  its  laminated  and  filamentous  condition,  when  such  does  appear, 
is  owing  to  its  glutinous  or  glue-like  consistence,  which  causes  it  to 
assume  a  factitious  arrangement  upon  being  drawn  or  inflated.  For 
example,  if  one  separates  two  muscles  for  a  short  distance,  the  cellular 
substance  between  them  becomes  unequal  and  furrowed,  without  losing 
its  cohesion  ;  but  if  they  be  farther  separated,  filaments  and  cylindrical 
columns  are  produced.  If  the  traction  be  then  suspended,  and  the 
muscles  replaced,  the  filaments  shorten,  and  are  finally  united  into  a 
consistent  mass  whose  parts  all  adhere  together.3 

While  such  tractions  are  going  on,  it  most  frequently  happens  that 
air  is  insinuated  into  the  cellular  substance,  from  which  comes  the 
appearance  of  small  cells  and  vesicles  ;  upon  the  escape  of  this  air,  the 
primitive  state  of  cohesion  is  restored,  and  upon  a  renewal  of  the 
traction,  cells  of  a  different  shape,  size,  and  appearance  arise.  Again, 
if  air  be  so  introduced,  one  may  push  it  in  any  direction,  separate  its 
globules,  collect  them  again,  and  into  larger  masses ;  vary  their  shape, 
and,  in  fine,  by  such  means  mould  the  supposed  cells  into  an  infinity  of 
forms.  From  these  considerations,  the  inference  is  plain,  that  when 
the  cellular  substance  is  drawn,  it  must  yield  itself  into  filaments  ;  when 
inflated,  as  the  air  acts  in  every  direction,  its  supposed  lamellae  must  be 
separated  and  assume  a  cellular  shape  ;  and,  by  the  application  of  both 
forces  at  once,  it  may  be  caused  to  assume  both  a  cellular  and  a  fila- 
mentous appearance.  Upon  the  whole,  Meckel  conceives  that  the  term 
Mucous  Tissue,  adopted  by  Bordeu,  is  much  more  exact  than  the  one 
of  Cellular  Tissue,  now  most  generally  used. 

Notwithstanding  the  general  similarity  of  cellular  substance  where- 
ever  found,  there  is  a  well  marked  difference  between  portions  of  it,  for 
example,  the  intermuscular  and  subcutaneous  cellular  substance,  when 
inflated  and  dried,  remains  permanently  lamellated,  whereas,  that 
which  makes  a  regular  tunic  to  the  alimentary  canal  and  other  hollow 
viscera,  when  treated  by  the  same  process,  is  permanently  filamentous 
and  resembles  so  much,  carded  cotton,  that  at  a  little  distance  their 
appearance  is  almost  identical.  The  lamellated  is  also  much  more 

1  Haller,  Beclard  Bichat,  Wm.  Hunter,  &c. 

2  Bordeu,  Recherclies  sur  le  Tissue  Muqueux  et  Celluleux,  Paris,  1790.     J.  F.  Meckel, 
Manuel  D'Anat.  vol.  i.  p.  105. 

a  J.  F.  Meckel,  loc.  cit. 


318 


INTEGT3MENTS. 


glutinous  to  the  touch  and  sight  than  the  filamentous.  The  filamentous 
cellular  substance  is,  in  its  normal  condition,  in  many  places  free  from 
fat  cells,  a  disposition  indispensable  to  the  preservation  of  the  cavities 
to  which  it  belongs. 

The  preceding  details  exhibit  the  condition  of  cellular  tissue  as  seen 
by  the  naked  eye,  but  under  the  microscope  some  modifications  are 
evident.  For  example,  it  is  found  to  be  made  principally  of  very  attenu- 
ated filaments  from  the  ssi^th  to  the  y^i^^th  of  an  inch  in  thick- 
ness, which  are  united  into  bundles  and  into  laminae.  These  filaments 
do  not  divide  into  branches  or  unite  one  with  another,  but  each  one 
keeps  distinct,  though  it  runs  parallel  with  the  contiguous  ones,  in  the 
same  bundle.  Their  course  is  also  serpentine  or  wavy,  which  may  be 
corrected  on  stretching,  but  returns  again  on  the  cessation  of  the  force. 

The  filaments  above  are  transparent  to  transmitted  light,  but  of  a 
white  color  to  reflected  light.  They  are  of  a  dense  milky  whiteness 
when  collected  in  thick  masses  to  form  tendons,  ligaments,  and  other 
white  fibrous  textures.  In  the  intervals  of  these  filaments,  is  found  an 
extremely  delicate  amorphous  or  hyaline  membrane. 

Associated  with  these  parallel  filaments  of  cellular  tissue,  there  are 

Fig.  99. 


The  two  elements  of  Areolar  Tissue,  in  their  natural  relations  to  each  other. — 1.  The  white  fibrous 
element,  with  cell-nuclei,  9,  sparingly  visible  in  it.  2.  The  yellow  fibrous  element,  showing  the 
branching  or  anastomosing  character  of  its  fibrill;E.  3.  Fibrillae  of  the  yellow  element,  far  finer  than 
the  rest,  out  having  a  similar  curly  character.  8.  Nucleolated  cell-nuclei,  often  seen  apparently  loose. 
— From  the  areolar  tissue  under  the  pectoral  muscle,  magnified  320  diameters. 

fibres  of  yellow  elastic  tissue  not  so  abundant,  but  which  may  be  ren- 
dered visible  by  acetic  acid,  which  makes  the  white  fibres  swell  up  and 
become  indistinct.  The  yellow  fibres  under  the  microscope  are  trans- 
parent and  colorless,  and  have  a  strong,  dark,  well-defined  outline. 


CELLULAR  TISSUE.  319 

They,  curl  up  especially  at  their  broken  ends,  divide  into  branches  and 
join  or  anastomose,  in  the  same  way  with  the  fibres  of  the  purest  elastic 
tissue.  For  these  causes  they  are  considered  identical  with  it.  Some 
are  very  small,  others  large;  they  lie  for  the  most  part  without  order  in 
the  midst  of  the  white  fibres,  but  sometimes  encircle  them.  These 
yellow  elastic  fibres  abound  in  the  sub-serous  and  sub-mucous  cellular 
tissue. 

The  cellular  tissue  like  all  others,  pre-exists  in  the  condition  of  a 
homogeneous  formative  mass  called  cytoblasteina,  which  corresponds  in 
animals  with  the  guin  so  abundant  in  the  nascent  parts  of  plants.  This 
gum  or  cytoblastema  appears  to  become,  according  to  the  observations 
of  Schleiden,1  turbid  from  the  evolution  of  minute  molecules.  In  a 
short  time  larger  molecules  are  noticed.  The  secondary  molecules 
augment  in  size  by  agglomeration  or  coagulation,  and  in  that  state 
constitute  cytoblasts,  in  which  the  secondary  granules  are  visible  as 
nuclei.  A  cytoblast  finally  reaches  its  full  size,  and  then  a  small  vesicle 
appears  on  it,  which  enlarges  and  becomes  a  cell.  The  cytoblast  is 
more  or  less  permanent,  and  is  for  some  time  visible  either  attached  to 
the  interior  of  the  cell  or  free  in  its  cavity.  The  observations  of 
Schwann  are  admitted  to  have  proved  the  exact  identity  of  the  pro- 
cess described,  as  compared  in  plants  and  in  animals.  The  process  of 
primitive  evolution,  therefore,  in  every  case  exhibits  the  stages  of  nu- 
cleoli,  nuclei  or  cytoblasts,  and  germinal  cells  surrounding  the  latter. 
Mirbel  had  previously  shown  that  the  ultimate  form  of  all  vegetable 
tissue  was  that  of  cells. 

In  the  earlier  stages  of  the  cell,  it  bears  the  relation  to  the  cytoblast 
which  a  watch  glass  has  to  the  watch,  but  finally  enlarges  so  as  to 
enclose  it.  Some  nuclei  are  permanent,  but  others  finally  disappear 
entirely.  The  cells  thus  formed  have  others  developed  in  their  interior, 

Fig.  100. 


Fig.  100  represents  an  organic  cell  of  the  developing  Areolar  Tissue,  isolated  and  highly  magnified, 
undergoing  the  division  of  the  extremities  of  its  prolongations  into  the  ultimate  filamentary  structure. 

1  Muller's  Physiology,  p.  49,  Bell's  edition. 


320  INTEGUMENTS. 

•which  by  their  reciprocal  pressure  become  polyhedral.  The  cells  of 
cellular  tissue  pass  from  the  above  nascent  state  into  one  of  an  elon- 
gated spindle-like  shape,  having  its  extremities  resolved  into  fine  fila- 
ments. The  filamentous  structure  finally  invades  the  whole  cell  except 
the  nucleus,  and  the  transformation  is  now  complete  by  its  running  into 
similar  adjoining  filaments.1 

The  cellular  tissue  is  remarkable  for  the  celerity  of  its  reproduction 
when  lost  by  accident.  The  process  is  the  same  as  in  the  nascent^state. 

Notwithstanding  the  perfect  continuity  of  the  mucous  or  cellular 
substance  throughout  the  body,  anatomists  for  the  ease  of  description 
have  divided  it  into  External  and  Internal. 

The  External  Cellular  Substance  (textus  cellulosus  intermedius, 
seu  laxus)  has  the  general  extent  and  shape  of  the  body  and  of  its 
organs,  so  that  if  it  were  possible  to  extricate  the  latter  from  their 
envelop,  it  would  present  a  chamber  for  the  lodgment  of  each  part. 
But  the  walls  of  these  chambers  would  not  all  be  of  the  same  thickness, 
as  the  quantity  of  cellular  substance  varies.  In  the  cranium  and 
spinal  cavity  there  is  very  little  of  it :  on  the  surface  of  the  head  and 
in  the  orbits,  more :  about  the  trunk,  both  internally  and  externally,  it 
is  abundant;  in  the  extremities  still  more  so,  where  it  penetrates 
between  the  muscles.  In  the  arm  pit,  in  the  groin,  and  in  the  neck, 
all  parts  where  much  motion  is  enjoyed,  it  is  unusually  abundant.  The 
foramina  of  the  cranium  and  of  the  spine  establish  the  points  of  con- 
nection of  the  cellular  substance  of  these  parts  with  others  adjacent. 
The  cellular  substance  of  the  face  is  continued  into  that  of  the  neck ; 
that  of  the  latter  is  continued  through  the  upper  opening  of  the  thorax- 
upon  the  viscera  of  this  cavity  ;  and  thence  through  the  openings  of  the 
diaphragm,  along  the  great  vessels  and  oesophagus  upon  the  viscera  of 
the  abdomen  and  pelvis.  The  cellular  substance  of  these  cavities  is 
again  continuous  with  the  deep-seated  cellular  substance  of  the  limbs 
at  the  arm  pit  and  at  the  groin.  The  trunk  of  the  body  being  enve- 
loped by  one  broad  sheet  of  cellular  substance,  it  is  continued  super- 
ficially to  the  limbs.? 

With  this  general  sketch  of  the  distribution  and  extent  of  cellular 
substance,  it  is  not  surprising  that,  in  certain  bad  cases  of  emphysema, 
the  air  shows  itself  everywhere,  even  at  points  the  most  remote  from 
the  lungs,  and  apparently  the  least  exposed  to  the  accident,  as  the 
interstices  of  muscles,  of  glandular  organs,  and  so  on.  It  will  also  now 

1  The  above  subject  has  also  been  treated  of  with  great  perspicuity  by  Valentin,  who  has 
investigated  closely  these  primordial   laws  of  growth.    -The  umbilical  cord  of  the  foetus  of 
about  seven  weeks  is  considered,  by  Dr.  Leidy,  very  favorable  for  observing  the  develop- 
ment of  cellular  tissue.     Quain  and  Sharpey,  p.  232,  vol.  i. 

Dr.  M.  Barry  advances  the  opinion  that  the  blood-corpuscles  or  globules  are  the  nuclei 
or  cytoblasts  of  the  primitive  cells,  from  which  all  the  animal  tissues  arise.  The  crystalline 
lens  he  considers  one  of  the  best  proofs  of  this  conversion.  Phil.  Trans.,  1840-41. 

2  For  a  detailed  account  of  the  inflections  of  the  cellular  substance,  the  student  may  con- 
sult with  advantage,  Bordeu,  loc.  cit.    These  inflections  are  the  Fasciae  of  modern  Surgical 
Anatomy. 

Bichat,  Anatomic  Generale  ;  Systeme  Cellulare,  Paris,  1818. 

Andreas  Bonn,  de  Continuationibus  Membranarurn,  in  Sandifort's  Thesaurus  Dissertationum, 
Rotterdam,  1769. 

Haller,  Element.  Physiol.  vol.  i.  1757. 


CELLULAR  SUBSTANCE.  321 

be  understood  how  this  varied  distribution  of  cellular  substance  and  its 
modified  texture,  have  been  the  inexhaustible  but  delusive  source  of 
anatomical  discoveries  and  supposed  novelties,  under  the  name  of 
fasciae,  sheaths  of  vessels,  and  so  on ;  and  will  continue  to  be  so,  to 
such  as  do  not  recollect  that  all  such  things  are  included  under  the 
general  character  of  this  tissue ;  and  that  each  muscle,  each  viscus, 
each  nerve,  and  each  blood-vessel,  has  its  own  particular  chamber  under 
this  multiform  arrangement,  which  chamber  may  be  traced  to  or  from 
any  other  point,  according  to  fancy.  At  the  same  time  it  should  be 
noted  that  many  of  the  laminae  have  a  condensed  form,  which  renders 
a  special  knowledge  of  them  of  the  greatest  use  to  the  surgeon,  and 
which  is  elsewhere  succinctly  pointed  out,  with  the  description  of  the 
respective  organs. 

Anatomists  who  lived  at  a  period  much  less  illuminated  than  the 
present  on  the  subject  of  the  elementary  tissues  of  the  body,  seem  to 
have  seized  upon  the  idea  of  the  universal  inflection  of  cellular  sub- 
stance over  the  surface,  and  through  the  texture  of  the  several  organs. 
Mangetus,1  without  pretending  to  originality,  but  in  alluding  freely  to 
the  observations  of  others,  says,  "Membrana  adiposa,  est  expansio 
cellulosa,  quae  totum  corporis  habitum,  paucissimis,  iisque  minimis  par- 
tibus  exceptis,  circumambit;  et  in  qua  materia  albicans  unctuosa,  sensu 
expers,  ad  partes  fovendas  ac  lubricandas  colligitur. — Haec  membrana 
cellulosa  seu  pinguedinosa,  non  tantum  in  exterioribus  corporis  reperitur ; 
sed  interius  in  intestinis,  mesenterio,  aliisque  prope  omnibus  partibus, 
non  exceptis  etiam  vasis  sanguiferis,  ut  suo  loco  videbimus,  observatur." 
And  in  describing  the  aponeurotic  covering  of  the  body  and  of  the 
limbs,  which  in  his  day  was  called  Membrana  Musculosa,  from  some 
false  notions  of  its  nature,  he  adds,  "  Dicitur  oriri  a  dorsi  vertebris, 
quia  scillicet  earum  spinis  firmiter  adhseret,  inibique  multo  quam  alibi 
usquam  robustior  conspicitur.  Usus  est,  musculos  universim  in  sua 
sede  firmare,  iisque  quasi  thecam  praestare,  in  qua  ut  supra  innuimus 
laxius  sibi  cohaerente,  lubrice  moveri  queant."  The  cellular  invest- 
ments of  the  muscles  the  same  author  calls  Membrana  Musculi  Propria, 
and  he  speaks  of  their  penetrating  between  the  fasciculi  of  muscles, 
and  most  evidently  those  of  the  glutaeus  magnus  and  deltoides. 

The  Internal  Cellular  Membrane  (textus  cellulosus  stipatus)  pre- 
sents itself  under  different  arrangements  according  to  the  organ  or 
part  whose  interstices  it  penetrates.  As  it  forms  in  the  muscles  an 
envelop  for  each  fasciculus  and  fibre,  if  the  latter  by  any  art  could 
be  withdrawn,  it  would  represent  a  congeries  of  fine  parallel  tubes.  In 
the  case  of  glandular  bodies  the  internal  cellular  membrane  imitates 
the  shape  of  their  lobes,  lobules,  and  acini  or  small  graniform  masses, 
and  may,  therefore,  be  compared  to  a  sponge.  In  the  hollow  viscera, 
as  the  stomach  and  bladder,  it  unites  their  successive  laminae  to  one 
another.  In  the  ligaments,  even  where  the  fibrous  structure  is  per- 
fectly evolved,  the  fibres  are  united  by  cellular  tissue  in  their  interstices. 
This  tissue  is  not  sufficiently  abundant  in  the  bones,  tendons,  or  carti- 
lages, to  be  very  distinct ;  but  from  what  is  seen  of  it  in  the  forming 

1  Theatrum  Anatomicum,  Geneva,  1716,  vol.  i.  ch.  iii. 
VOL.  I.— 21 


322  INTEGUMENTS. 

stage  of  the  embryo,  it  is  nevertheless  ascertained  to  be  the  base  of 
every  part.  In  glandular  textures  it  is  frequently  spoken  of  under  the 
name  of  parenchyma  in  connection  with  their  acini. 

Most  of  the  membranous  textures  of  the  body  may  by  maceration 
be  resolved  into  this  pulpy  or  cellular  tissue,  so  that  anatomists,  with- 
out hesitation,  assert  that,  under  various  degrees  of  consistence,  it 
forms  the  skin,  the  serous  membranes,  the  vessels,  the  ligaments,  the 
fasciae,  in  short,  almost  everything  excepting  the  bones,  the  muscles,  the 
nervous  system,  and  the  glands,  and  they  only  depart  from  it  in  having 
their  particles  deposited  in  its  interstices.1  Meckel  even  adds  to  the 
list  the  epidermis. 

The  term  mucous  tissue  was  substituted  for  that  of  cellular,  by  Bor- 
deu,2  owing  to  its  glue-like  consistence,  and  to  its  resemblance  to  the 
corpus  mucosum  of  vegetables.  Notwithstanding  its  propriety  on  these 
grounds,  yet,  as  the  lining  membrane  of  all  the  hollow  viscera  has  the 
same  name,  some  confusion  may  be  produced  unless  one  bears  in 
mind  the  distinction.  Bordeu  has  expressed  the  character  of  the  in- 
ternal cellular  membrane  very  forcibly  in  saying,  that  in  embryos  all 
their  organs  are  species  of  buds,  which  vegetate  in  the  cellular  tissue, 
like  plants  do  in  the  open  air,  or  their  roots  in  the  ground  ;  and  that 
each  one  having  an  apartment  of  its  own,  this  apartment  is  to  it  a 
cellular  atmosphere,  which  keeps  in  a  perfect  relation  with  the  action 
of  the  organ.3 

In  tracing  many  of  the  laminae  of  the  cellular  substance,  we  find, 
that  as  life  advances,  they  assume  a  more  fibrous  character  than  what 
they  possessed  in  infancy;  this  also  occurs  when  they  are  pressed  upon 
by  tumors,  or  irritated  from  any  other  causes.  This  disposition  of  the 
cellular  substance  to  assume  a  ligamentous  character,  in  many  of  the 
attachments  which  are  formed  between  the  two  tissues,  frequently 
leaves  it  doubtful  with  which  the  membrane  under  examination  should 
be  classed ;  in  some  individuals  the  fibrous  substance  is  predominant, 
and  in  others  the  cellular. 

In  addition  to  the  uses  of  the  cellular  substance  in  forming  a  nidus 
for  the  deposit  of  all  the  molecules  of  the  body,  and  in  circumscribing 
each  organ,  so  as  to  keep  it  distinct  from  the  contiguous  ones  of  a  dif- 
ferent character,  its  elasticity  and  yielding  nature  permit  it,  in  the 
movements  of  the  several  parts  upon  each  other,  to  change  its  position, 
and  upon  the  cessation  of  the  active  cause,  to  re-establish  itself.  Its 
extreme  flexibility  is  kept  up  by  a  continued  exhalation  of  moisture 
from  the  arteries  that  ramify  through  its  texture.  This  cellular  serosity, 
when  an  animal  is  recently  killed,  and  its  internal  parts  exposed  to  a 

1  Beclard,  Anat.  Gen.  p.  141.     Haller,  loc.  cit.  p.  19;  vol.  i.  p.  113. 

2  Loc.  cit. 

3  Loc.  cit.  p.  05.     Recherches  Anatorniques  sur  les  Glands,  Paris,  1752.     Also,  an  Exposi- 
tion of  the  Ptiysiol.and  Pathol.  Doctrines  of  Theoph.  Bordeu,  understood  to  be  from  the  pen 
of  a  learned  friend,  R.  La  Roche,  M.  D.,  in  the   North   American   Med.   and  Surg.  Journal. 
Philad.  April,  1826. 


ADEPS.  323 

cold  atmosphere,  rises  in  the  form  of  vapor,  and  has  a  particular  smell. 
It  is  more  abundant  in  certain  parts  than  in  others ;  and,  as  a  gene- 
ral rule,  where  there  is  the  least  adipose  matter.  Indeed,  these  two 
substances  seem  to  exist  in  an  inverse  ratio  :  in  a  person,  for  example, 
who  has  died  very  fat,  the  parts  are  comparatively  dry;  whereas,  in 
such  as  have  all  the  adipose  matter  wasted  by  a  lingering  disease,  there 
is  a  humidity  which  quickly  disposes  to  putrefaction ;  a  fact  frequently 
exemplified  in  our  dissecting-rooms.  The  cellular  serosity  is,  conse- 
quently, more  abundant  in  the  scrotum,  in  the  eyelids,  and  in  the  penis. 
Bichat  informs  us,  that  he  has  satisfied  himself,  by  experiments,  of  its 
augmentation  during  digestion,  during  heavy  perspirations,  and  after 
sleep ;  which  will  account  for  the  swelling  of  the  eyelids,  so  commonly 
observed  in  the  morning,  upon  rising. 

This  serosity  is  albuminous,  as  proved  by  its  being  coagulated  by 
alcohol,  and  by  the  mineral  acids.  It  is  removed  by  the  absorbents ; 
assisted  by  the  tonic  contraction  of  the  cellular  membrane,  according 
to  M.  Be'clard.1  The  latter  author,  indeed,  goes  on  to  say,  that  the 
cellular  membrane  is  the  essential  organ  of  absorption,  by  which  the 
skin  and  the  villosities  of  the  internal  membrane  of  the  hollow  viscera 
perform  this  function.  That  the  substances  introduced  through  it  into 
the  blood-vessels,  no  doubt,  in  doing  so,  undergo  some  kind  of  elabora- 
tion, in  the  same  way  that  those  do,  which  are  deposited  in  its  inter- 
stices for  the  growth,  repair,  and  changes  of  the  body. 


CHAPTER  II. 
OF  THE  FAT  (ADEPS). 

THE  Adeps,  in  subjects  not  much  emaciated,  is  found  beneath  the 
skin,  between  it  and  the  fasciae,  and  in  the  layers  of  common  cellular 
substance  which  are  next  to  the  muscles:  as  on  the  face,  the  neck,  the 
trunk  of  the  body,  the  buttocks,  the  limbs,  the  palms  of  the  hands, 
and  the  soles  of  the  feet.  In  the  adult,  it  is  also  found  between  the 
serous  membranes  and  the  cavities  which  they  line,  as  in  the  thorax 
and  abdomen ;  it  is  also  found  between  the  laminae  of  these  membranes, 
as  in  the  omenta,  mesentery,  and  so  on.  It  likewise  exists  in  the  inter- 
stices between  muscles;  in  the  bones,  and  elsewhere  ;  so  that  its  whole 
amount  is  estimated  at  about  one-twentieth  of  the  entire  weight  of  the 
body.  There  are,  however,  certain  portions  of  the  body,  where  its 
presence  would  have  been  very  inconvenient :  they,  accordingly,  are 
destitute  of  it;  to  wit,  the  interior  of  the  cranium,  of  the  ball  of  the 
eye,  the  nose,  the  ear,  the  intestinal  canal,  the  eyelids,  the  scrotum, 
the  penis,  the  labia  interna,  and  the  substance  of  the  glands. 

The  adeps  is  of  a  yellowish  color,  and  of  a  semi-fluid  state  in  the 
living  body:  when  after  death  it  has  got  a  few  degrees  below  the  stand- 

1  Anat.  G6n.  p.  149. 


324  INTEGUMENTS. 

ard  of  animal  heat,  it  becomes  somewhat  solidified,  and  then  appears 
in  small  aggregated  masses  of  different  shapes  and  sizes. 

In  chemical  composition  it  differs  from  all  other  parts  of  the  body 
by  the  absence  of  nitrogen,  and  is  formed  of  oxygen,  hydrogen,  and 
carbon,  which  render  it,  in  animals,  a  very  suitable  article  for  candles 
and  lamps.  According  to  the  analysis  of  Chevreul,1  it  consists  of  two 
kinds  of  matter,  Elain  and  Stearin;  the  former  of  which  remains  fluid 
at  the  freezing  point,  while,  as  mentioned,  the  other  becomes  solid  by 
a  very  small  abatement  of  its  living  temperature.  The  application  of 
porous  paper  enables  one  to  separate  them  in  a  small  way.  Strong 
mechanical  pressure  does  the  same  thing,  and  is  now  much  used  in  the 
United  States,  in  the  manufacture  of  lard  oil  for  domestic  purposes. 

The  substance  called  Margarin  also  exists  in  most  fats,  and  is  the 
principal  constituent  of  the  human;  hence  the  comparative  softness  of 
the  latter  to  mutton  tallow,  where  stearin  predominates.  Stearin  lique- 
fies at  148°;  Margarin  at  118°,  and  Elain  remains  fluid  at  zero  of 
Fahrenheit. 

The  adeps,  though  lodged  in  the  cellular  substance,  is  accommodated 
there  under  different  circumstances  from  the  cellular  serosity.  This 
doctrine  was  first  promulgated  by  Dr.  Wm.  Hunter,2  and  upon  the  fol- 
lowing grounds :  That  certain  parts  of  the  cellular  membrane  are  des- 
titute of  it;  that  in  persons  who  have  died  from  dropsy,  the  portions 
of  the  cellular  membrane  which  originally  contained  fat  have  a  more 
ligamentous  condition  than  others ;  to  wit,  those  on  the  loins  next  to 
the  skin,  more  than  the  stratum  next  to  the  lumbar  fascia ;  that  water 
or  fluids  pass  readily  from  a  higher  to  a  lower  part  of  the  cellular  mem- 
brane, either  when  extravasated  naturally  or  injected;  that  oil,  when 
injected  artificially,  subsides  in  the  same  way,  and  has  a  doughy  or 
redematous  feel,  yielding  readily  to  pressure  and  pitting,  whereas,  fat 
never  shifts  its  position  simply  from  gravitation. 

From  these  several  causes,  Dr.  Hunter  adopted  the  opinion  that  the 
fat  of  the  cellular  membrane  is  lodged  in  peculiar  vesicles,  and  not,  as 
the  water  of  anasarca,  in  the  reticular  interstices  of  parts.  This  idea 
has  been  generally  adopted,  and  the  lobules  of  fat,  when  examined  with 
a  microscope,  are  seen  to  be  composed  of  small  grains  or  vesicles,  each 
one  having  a  pedicle  furnished  from  the  adjacent  blood-vessel.  The 
parietes  of  the  vesicles  are  extremely  fine,  but  arranged  in  the  same 
way  with  the  pulp  of  oranges,  lemons,  and  such  kind  of  fruit. 

The  preceding  observations  on  the  existence  of  distinct  vesicles  for 
the  reception  of  fat,  are  sufficiently  proved  by  the  microscope.3  The 
vesicles  are  far  from  uniformity  in  size.  A  very  common  diameter  is 
the  g  J  oth  of  an  inch,  but  they  vary  from  the  7  o^Tjth  to  the  2£ ^th.  These 
vesicles  are  composed  of  organic,  independent  cells,  which  have  the 
faculty  of  eliminating  from  the  blood,  the  adeps,  precisely  upon  the 
same  principle  that  the  organic  cells  of  a  gland,  as  the  liver  and  mamma, 
eliminate  bile  or  milk.  The  fat  cells,  are  sometimes  dispersed  at  wide 
intervals  in  the  cellular  or  areolar  tissue,  but,  in  other  points,  they  are 

1  Annales  de  Cliimie,  vol.  xciv. 

2  Medical  Observations  and  [nquiries,  London,  1762. 

3  Gerber's  Elements  of  General  Anatomy,  p.  133,  London,  1842. 


ADEPS. 


325 


aggregated  in  masses,  having  a  common  envelop  of  laminated  cellular 
substance.  The  interstices  of  such  groups  are  permeated  by  blood- 
vessels, making  a  minute  net-work,  for  the  purpose  of  furnishing  the 
proper  elements  to  the  cells.  In  particular  parts  of  the  body,  as  upon 
the  soles  and  palms,  but  also  elsewhere,  the  cellular  substance  is  tra- 
versed by  bands  and  filaments  of  fibrous  matter  for  the  purpose  of 
holding  them  in  place,  and  also  of  securing  the  skin  from  being  torn 
off  or  dislodged.  The.  ends  of  the  fingers  and  toes  exhibit  striking 
arrangements  of  that  kind. 


Fig.  101. 


Fig.  102. 


Fig.  101.  Areolar  and  Adipose  Tissue.— a,  a.  Fat  cells.    6,  b.  Filaments  of  areolar  tissue. 
Fig.  102.  Capillary  net  work  surrounding  the  Fat  cells. 

Persons  who  are  enormously  fat  have  in  the  composition  of  the 
latter  a  much  higher  proportion  of  Elain,  hence,  in  their  dissection  the 
hands  of  the  operator,  especially  in  warm  weather,  are  kept  streaming 
with  the  oil.  This  portion  of  their  fat,  too,  is  disposed  to  gravitate  to 
the  lowest  point  during  life,  hence  the  ankles  are  tumid. 

Fat  is  more  abundant  in  the  female  than  in  the  male,  and  in  both 
sexes  it  is  removed  as  life  declines.  In  the  infant  the  fat  is  found  at 
the  surface  of  the  body  chiefly,  little  or  none  existing  in  the  interstices 
of  muscles,  and  in  the  cavities. 

Development. — The  fat  cell  is  visible  in  the  human  embryo  about  the 

Fig.  103. 


Fat  Vesicles  from  the  Omentura,  magnified  about  three  hundred  diameters,  and  assuming  the  polyhe- 
dral form,  from  pressure  against  one  another.    The  capillary  vessels  are  not  represented. 


326  INTEGUMENTS. 

fourteenth  week  of  conception.  The  cells  are  there  insulated,  but  by 
the  end  of  the  fifth  month  they  are  aggregated  into  groups.  They 
are  smaller  when  first  seen  than  afterwards.  In  the  embryo  these  cells 
are  furnished  with  a  nucleus  attached  to  the  inside  of  the  cell  wall  and 
containing  one  or  two  nucleoli :  it  generally  disappears  afterwards. 

Its  uses  are  not  fully  understood.  At  some  points  it  serves  to 
diminish  pressure,  as  on  the  hands  and  feet :  at  others  it  fills  up  inter- 
stices ;  it  is  also  a  bad  conductor  of  caloric,  and  may,  therefore,  serve 
in  retaining  animal  heat.  But  its  most  general  application  is  to  the 
purposes  of  nutrition,  it  being  one  of  those  forms  which  nutritive  mat- 
ter assumes  previously  to  being  perfectly  assimilated.  This  is  very 
fully  manifested  in  hibernating  animals,  which  being  fat  in  the  begin- 
ning of  their  torpid  state,  return  from  it  quite  lean*;  and  in  insects 
which,  during  their  repose  in  the  chrysalis  form,  live  upon  their  own 
fat  while  undergoing  the  metamorphosis  into  the  perfect  animal.1 

1  B£clard,  Anat.  Gen.  p.  170. 


BOOK  II. 


PART   II. 

OF  THE  DERM01D  COVERING. 

THE  Dermoid  Covering,  or  Tissue  of  the  body,  consists  in  the  Skin ; 
its  Sebaceous  and  Perspiratory  organs:  the  Nails;  and  the  Hair. 


CHAPTER  I. 
OF  THE  SKIN. 


THE  Skin  (Pellis,  Cutis,  fop/ua)  is  extended  over  the  whole  surface  of 
the  -body,  and  thereby  constitutes  a  complete  investment  of  it.  At  the 
orifices  of  the  several  canals  which  lead  into  the  interior  of  the  body, 
as  the  mouth,  nose,  vagina,  anus,  and  urethra,  it  does  not  cease  abrupt- 
ly, but  is  gradually  converted  into  the  mucous  membrane  of  the  part, 
so  that  it  is  plainly  continuous  with  it.  At  certain  places,  on  the  mid- 
dle line  of  the  body,  the  junction  of  the  skin  of  the  two  sides  is  indi- 
cated by  a  change  in  its  appearance,  called  Raphe;  as  on  the  upper 
lip;  from  the  navel  to  the  pubes;  on  the  scrotum,  and  in  the  perineum; 
in  all  of  which  places,  in  the  development  of  the  foetus,  the  two  sides 
of  the  body  are  later  in  uniting  than  elsewhere. 

The  color  of  the  skin  varies  in  different  nations:  it  is  black  in  the 
Negro;  of  a  copper  color  in  the  American  Indian;  bronzed,  or  tawny, 
in  the  Arabian;  and  white  in  Europeans  and  their  descendants.  It  is 
also  subject  to  various  shades,  from  the  mixture  of  these  races,  and 
from  the  influence  of  climate  ;  its  general  tendency  being  to  turn  dark 
on  parts  exposed  to  the  influence  of  tropical  heat  and  light. 

The  external  surface  of  the  skin,  or  that  which  is  free,  has  on  it  a 
great  multitude  of  wrinkles;  some  of  them  depend  upon  the  subjacent 
muscles,  as  on  the  forehead  and  face  ;  some  are  caused  by  the  flexions 
of  the  articulations,  and  are  to  be  seen  at  all  of  these  places  on  the 
limbs  ;  in  addition  to  which,  where  there  is  much  emaciation  of  the 
parts  beneath,  the  skin  not  having  sufficient  elasticity  to  accommodate 
itself  to  their  state,  is  thrown  into  other  wrinkles,  and  sometimes 
into  loose  folds.  Finer  wrinkles  of  another  description  are  also  found 
on  the  skin,  arranged  in  various  angular  and  spiral  directions:  they 


328  INTEGUMENTS. 

depend  on  an  entirely  different  cause,  which  will  be  treated  of  else- 
where. 

The  skin  abounds  in  hairs,  which  vary  in  fineness  and  in  length  ac- 
cording to  the  region  over  which  they  are  distributed :  it,  likewise, 
presents  many  small  pits,  or  follicles,  which  are  the  orifices  of  sebaceous 
glands.  A  finer  description  of  pores,  which  are  visible  only  to  the 
assisted  eye,  are  the  ends  of  the  sweat  ducts,  and  there  are  others 
which  are  supposed  to  be  the  orifices  of  exhalants  and  of  absorbents, 
but  this  is  not  so  certain. 

The  internal  surface  of  the  skin  is  connected  to  subjacent  parts  by 
the  cellular  tissue,  which  permits  a  considerable  sliding  of  it  backwards 
and  forwards  on  most  parts  of  the  body.  On  other  parts,  however, 
this  is  restrained,  as  on  the  crapium,  the  palms  of  the  hands,  and  the 
soles  of  the  feet,  by  ligamentous  fibres  passing  to  it  from  the  fasciae 
and  bones  below.  A  very  interesting  attachment  of  this  kind  exists 
on  the  fingers,  where  a  plane  of  ligamentous  fibres  is  seen  going  from 
each  side  of  the  lower  end  of  the  first  phalanx,  downwards,  to  be  in- 
serted into  the  skin,  half  an  inch  or  an  inch  off;  and  the  bulbous  ends 
of  the  fingers,  thumbs,  and  toes  exhibit  also  numerous  fine  ligament- 
ous filaments  of  the  same  description,  passing  amidst  the  granules  of 
fat  from  the  last  phalanges. 

Since  the  first  observation  of  Malpighi,  on  the  tongue  of  a  bullock, 
whereby  he  ascertained  that  its  integuments  consisted  in  three  layers ; 
and  the  discovery  of  a  similar  arrangement  on  other  portions  of  the 
integuments  by  Ruysch;1  anatomists  have,  for  the  most  part,  admitted 
the  skin  to  consist  of  three  laminae,  the  Cutis  Vera,  the  Rete  Mucosum, 
and  the  Cuticula.  The  latter  two,  however,  have  been  recently  iden- 
tified, according  to  the  opinion  of  Albinus  at  a  former  period,  owing 
to  their  common  origin  as  an  epidermoid  layer. 


SECT.  I. — OF  THE  CUTIS  VERA. 

The  True  Skin  (Cutis  vera,  Derma,  Corium)  is  the  deepest,  or  the 
layer  next  to  the  cellular  substance.  Its  thickness  varies  according  to 
age,  sex,  and  the  region  of  the  body  over  which  it  is  stretched ;  on  the 
trunk  it  is  thicker  behind  than  it  is  in  front;  on  the  limbs,  thicker  on 
their  external  than  on  their  internal  faces  or  semi-circumferences.  On 
the  mammae,  the  penis,  scrotum,  and  external  ear,  its  tenuity  is  re- 
markable. When  uninjected,  it  is  perfectly  white  in  people  of  all 
complexions,  and  in  the  living  state  has  a  semi-transparency  that  per- 
mits the  blood  to  be  seen  in  the  vessels  beneath  it. 

The  internal  surface  of  the  true  skin  is  so  blended  with  the  cellular 
substance,  that  in  the  recent  subject  there  is  a  difficulty  in  distinguish- 
ing where  one  terminates  and  the  other  begins,  yet  they  may  be  sepa- 
rated by  maceration  so  as  to  determine  this  limit ;  mortification  of  the 
cellular  substance  sometimes  does  the  same  thing ;  and  in  the  ham, 
cured  by  salting  and  smoking,  the  true  skin,  after  boiling,  may  be 

1  Thesaurus  Auat.  ix. 


CUTIS  VERA.  329 

stripped  off  with  but  little  difficulty.  In  either  of  these  cases  the  in- 
ternal surface  of  the  latter  is  seen  to  be  studded  with  small  areolar 
depressions,  caused  by  the  projection  of  granular  masses  of  adeps ; 
the  margins  of  these  alveoli  are  the  principal  points  of  adhesion  to  the 
subcutaneous  cellular  tissue,  while  their  bottoms  are  pierced  with  small 
openings  that  lead  through  the  skin. 

The  external  surface  of  the  true  skin  is  covered  with  very  fine  Pa- 
pillae, or  villi  (papillae  tactus],  that  are  readily  brought  within  the 
observation  of  the  naked  eye,  by  maceration,  when  protracted  long 
enough  to  permit  the  removal  of  the  cuticle.  They  constitute  the 
Neurothelic  apparatus  of  Breschet.  The  projections  on  the  tongue 
are  very  similar  to  them,  and  the  whole  are  designated  as  the  papillary 
body.  These  cutaneous  papillae  are  particularly  distinct  at  the  bulb- 
ous ends  of  the  fingers  and  toes,  upon  the  palms  and  soles,  on  the  lips, 
on  the  glans  penis,  and  the  nipple ;  in  other  parts  they  are  not  so  evi- 
dent, but  still  there  should  be  no  doubt  of  their  existence.  On  the 
hands  and  feet  they  are  arranged  in  double  rows  or  files,  which  occa- 
sion the  semicircular  and  spiral  turns  of  small  wrinkles  or  ridges  at  the 
ends  of  the  fingers  and  toes ;  and  the  transverse,  oblique,  and  curved 
ones,  on  other  parts  of  the  soles  and  palms.  The  small,  triangular, 
lozenge-shape,  and  multangular  elevations  of  the  cutis  vera,  seen  else- 
where on  its  external  surface,  are  caused  rather  by  its  contraction  than 
by  the  papillae. 

These  papillary  projections  resemble  very  much  conoidal,  cotton-like 
filaments,  standing  up  from  the  twelfth  to  the  third  of  a  line,  or  there- 
abouts, from  the  surface  of  the  skin :  they  are  by  no  means  so  long  as 
the  villi  generally  of  the  intestines,  and,  like  them,  consist  in  very  de- 
licate ramifications  of  nerves  and  blood-vessels,  united  by  cellular  tissue. 
In  places  where  these  papillae  are  less  abundant,  the  cutis  vera  is  not 
so  vascular  or  sensitive.  They  readily  receive  a  fine  injection,  and,  if 
the  cuticle  be  afterwards  separated  by  maceration,  their  vascularity  is 
very  distinct,  as  well  as  a  tufted  surface  from  subordinate  projections 
from  them,  especially  in  the  feet.  Their  nerves  are  destitute  of  neu- 

Fig.  104. 


Distribution  of  the  Nerves  of  the  Papilla?  at  the  extremity  of  the  human  thumb,  as  seen  in  a  thin 
perpendicular  section  of  the  skin. 

rileme.1     The  nerves  and  the  blood-vessels  end  in  terminal  loops.     The 
structure  of  the  papillae  has  been  especially  studied  by  Pappenheim. 

1  Beclard,  Anat.  Gen. 


330  INTEGUMENTS. 

The  texture  of  the  true  skin  is  filamentous;  the  fibres  which  compose 
it,  by  their  irregular  intermixture,  resolve  it  into  a  sheet  of  net-work 
or  areolae,  the  meshes  of  which  are  sufficiently  large  in  some  parts  to 
permit  the  introduction  of  the  head  of  a  small  pin.  The  meshes,  though 
they  are  larger  and  more  distinct  on  the  internal  than  on  the  external 

Fig.  105. 


Distribution  of  Capillaries  in  the  papillae  of  the  skin  of  the  fingers. 

surface  of  the  true  skin,  open,  however,  upon  the  latter  surface ;  hav- 
ing passed  through  the  skin  obliquely,  after  the  manner  of  the  ureters 
through  the  coats  of  the  bladder.  Those  intervals  between  the  fibres 
of  the  skin  are  rendered  very  obvious  after  maceration  of  a  month  or 
two,  or  after  skin  has  been  tanned.  They  serve  to  transmit  hairs, 
blood-vessels,  nerves,  sweat-ducts,  absorbents,  and  exhalant  vessels 
also  if  such  exist.  These  interstices  communicate  freely  with  the  cel- 
lular substance,  for  in  many  cases  of  anasarca,  blisters,  when  made 
upon  a  depending  part,  empty  the  cellular  membrane  of  water  almost 
as  quickly  as  scarifications  ;*  but  if  the  blisters  inflame,  they  discharge 
inconsiderably,  owing  to  the  interstices  being  shut  up  by  lymph,  and 
by  the  tumefaction  and  fullness  of  the  parts.  The  same  is  observable 
in  scarifications. 

The  tissue  which  composes  the  true  skin  seems  to  be  a  mixture  of 
cellular  substance  and  fibrous  matter ;  with  a  striking  predominance  of 
the  latter  in  most  parts  of  the  body,  though  its  proportion  varies  con- 
siderably, being  more  abundant  on  the  thicker  parts  of  the  skin,  while 
it  is  scarcely  discernible  on  the  thinnest.  The  following  coincidences 
of  dermoid  with  ligamentous  or  desmoid  tissue  are  observable.  It  be- 
comes yellow  and  transparent  on  being  boiled,  and  a  continuation  of 
the  process  dissolves  it  into  gelatin.  It  resists  putrefaction  for  a  long 
time;  is  remarkably  tenacious,  Contrary,  however,  to  white  liga- 
mentous matter,  it  is  extensible  and  elastic,  though  this  property  may 
arise  from  the  oblique  intertexture  of  its  fibres ;  as  a  bandage  from  a 
piece  of  muslin,  when  torn  longitudinally  or  transversely,  is  inelastic, 
but  if  it  be  cut  bias,  is  then  very  elastic.  The  application  of  tannin 
increases  its  resistance,  and  makes  it  one  of  the  strongest  animal  sub- 
stances known  in  human  arts. 

The  fibrous  structure  of  true  skin  is  principally  the  white  variety,  as 
in  common  fibrous  and  areolar  tissues,  and  intermixed  with  them  is  the 
yellow  elastic  tissue,  but  in  much  smaller  amount ;  the  proportion  of 
each  to  the  other  varies  largely  in  different  regions. 

The  external  surface  of  the  true  skin  is  so  close  that  the  intervals 

1  W.  Hunter,  loc.  cit. 


KETE  MUCOSUM.  331 

of  its  fibres  require  assistance  to  the  naked  eye  for  satisfactory  exami- 
nation. This  surface  is  supposed  from  its  smoothness  to  be  furnished 
with  a  homogeneous  basement  membrane  or  membrana  propria.  Its 
properties  would  also  lead  to  such  a  conclusion,  difficult  as  it  is  of 
proof. 

The  cutis  vera  is  very  vascular,  and  abounds  also  in  nerves  and  ab- 
sorbents. The  demonstration  of  the  last-,  on  its  outer  surface,  has 
been  accomplished  by  Tiedemann,  Lauth,  and  Fohman. 

The  skin  has  a  very  strong  power  of  contraction,  which  is  manifested 
in  an  amputation,  in  a  long  incised  wound,  or  when  a  sensation  of 
chilliness  exists,  as  in  an  ague  or  from  the  application  of  cold.  Owing 
to  the  diminution  in  size  of  its  areolae,  its  external  surface  then  be- 
comes wrinkled,  rough,  and  studded  with  projecting  points,  constituting 
the  Cutis  Anserina. 


SECT.  II. — OF  THE  BETE  MUCOSUM. 

The  Mucous  Net,  or  Rete  Mucosum,1  of  Malpighi,  is  the  inner  sur- 
face of  the  Epidermic  layer  of  the  skin,  and  is  that  in  which  resides 
the  color  of  the  several  races  of  men.  It  covers  every  part  of  the 
surface  of  the  cutis  vera;  its  existence,  however,  is  not  so  obvious  be- 
neath the  nails  and  about  the  junction  of  the  skin  with  mucous  mem- 
branes, as  it  is  elsewhere ;  though  it  exists  also  at  these  several  places, 
but  much  finer.  It  is  so  extremely  thin,  and  of  such  a  soft  mucilagi- 
nous consistence,  that  it  is  difficult  to  separate  it  as  a  distinct  lamina, 
either  by  maceration  or  by  any  other  means ;  for  it  most  commonly 
peels  off  by  adhering  to  the  cuticle,  after  the  manner  of  a  pigment. 
It,  however,  by  good  management,  may  be  fairly  raised  as  a  membrane, 
and  separated  for  a  certain  distance,  from  the  other  two  coats  of  the 
skin. 

Fine  as  this  membrane  is,  it  would  seem,  from  the  observations  of 
Mr.  Cruikshank2  upon  a  negro  dead  from  small-pox,  and  upon  a  pre- 
paration executed  in  London,  by  the  late  Dr.  Baynham,  of  Virginia,3 
and  from  more  recent  experiments  in  Paris,  by  M.  Gaultier,4  that  it 
consists  in  several  layers.  1.  Upon  the  inequalities  or  papillae  of  the 
cutis  vera,  there  is  a  layer  called,  by  M.  Gaultier,  Bloody  Pimples 
(Bourgeons  Sanguins),  but  which,  in  the  opinion  of  some  other  anato- 
mists, are  only  the  papillae  themselves  of  the  cutis  vera.  2.  Then 
there  is  a  very  thin  and  transparent  coat,  called  from  its  color,  Tu- 
nica Albida  Profunda :  it  is  especially  visible  in  the  negro,  under  the 
colored  horns  and  scales  of  animals,  and  beneath  the  nails  of  white 
persons.  3.  Over  this  layer  is  spread  another  (the  Gemmula),  which 
contains  the  coloring  matter  of  the  several  complexions  of  the  human 
family,  and  consists  in  a  multitude  of  dark  brown  points  or  granules 
in  the  negro ;  it  is  visible  also  in  those  forms  of  disease  called  ephe- 

1  Caldani,  Icon.  Anat.  pi.  xci.      Albinus,  Annot.  Acad.  Leyden,  1756.    Ruysch,  Thes. 
Anat.  ix. 

2  Expts.  on  Perspiration,  London,  1795. 
*  Wistar's  Anat.  vol.  i.  p.  394. 

4  Recherches  sur  la  Peau,  Paris,  1809 ;  in  Anat.  de  1'Homme,  par  J.  Cloquet,  pi.  cxvii. 


332  INTEGUMENTS. 

lides  (freckles),  by  the  French,  where  the  skin  becomes  spotted ;  it  is 
not  so  distinct  in  the  healthy  state  of  the  white  individual.  4.  The 
last  lamina  of  rete  mucosum  is  called,  by  M.  Gaultier,  Tunica  Albida 
Superficialis,  from  its  whiteness  and  superficial  situation ;  in  many 
animals  it  is  very  distinct;  in  the  negro  somewhat  so,  but  in  the  white 
it  is  not  to  be  seen  except  under  the  nails,  about  the  hair,  and  under 
accidental  horny  excrescences. 

These  observations  of  M.  Gaultier  have  been  verified  by  M.  Dutro- 
chet,1  in  experiments  upon  the  texture  of  the  skin  of  vertebrated  ani- 
mals; and  were  generally  acknowledged  by  the  French  anatomists. 
In  negroes,  in  cutting  through  the  skin  of  the  sole  of  the  foot,  from 
heel  to  toe  perpendicularly  to  the  furrows,  this  arrangement  is  readily 
recognized;2  and  when  it  has  become  indistinct,  it  may  be  improved  by 
immersing  the  skin  for  three  or  four  days  in  lime-water,  or  a  solution 
of  potash  or  barytes,  and  afterwards  keeping  it  the  same  length  of 
time  in  a  solution  of  corrosive  sublimate.  Blisters  also  elucid-ite  this 
point  on  other  parts  of  the  body :  the  fluids  being  locally  attracted 
there,  infiltrate  the  rete  mucosum,  and  separate  in  part  its  layers,  so 
as  to  form  a  vesicle  frequently  very  thick,  particularly  in  fat  persons. 

The  rete  mucosum  is  very  readily  affected  by  the  Salt  antiseptic 
mixture,3  so  that  it  becomes  dissolved,  and  thereby  allows  the  cuticle 
to  loosen  from  the  cutis  vera.  This  fact,  repeatedly  noticed  in  the  use 
of  the  injection  and  for  years,  I  attributed  for  a  long  time  to  putrefac- 
tion, through  mistaken  views  of  its  real  character.  I  am  now  satisfied 
that  it  is  the  result  of  the  solvent  power  of  the  alkali  in  this  injection: 
and,  as  the  latter  acts  so  decidedly  on  the  central  masses  of  the  nerv- 
ous system  in  softening  them,  probably  from  the  adipose  matter  con- 
tained in  them,  it  is  hence  not  illogical  to  conclude,  that  the  rete 
mucosum  itself  has  a  large  proportion  of  neurine  in  its  composition, 
which  idea  is  in  harmony  with  the  sensibility  of  the  external  surface  of 
the  cutis  vera.  Another  cause  has  been  suggested  to  me  by  Dr.  Leidy, 
to  wit,  the  alkali  acting  as  a  solvent  on  the  new  epidermic  formation 
or  cells.  This  injection  has  a  similar  softening  influence  on  all  mucous 
membranes,  making  them  almost  liquescent. 

The  scrotum  of  the  negro  is  well  suited  to  the  exhibition  of  the  rete 
mucosum,  as  it  is  there  very  distinct.  It  is  universally  much  thicker 
and  better  marked  in  the  negro  than  in  any  other  race.  From  its  ex- 
treme tenuity  in  the  whites  its  existence  in  them  has  by  some  persons 
been  doubted,  but  erroneously,  as  in  them  also  its  change  of  color, 
from  the  influence  of  the  sun,  is  readily  demonstrated.  There  are  in 
fact  few  persons,  perhaps  none,  so  white,  but  what  a  slight  tinge  of 
yellow  exists  in  their  skins ;  which  may  be  proved  by  contrasting  them 
with  any  perfectly  white  surface,  as  snow,  bleached  paper,  or  linen. 
This  slight  tinge  of  yellow  is  increased  to  an  olive  color  by  the  sun's 
rays,  and,  in  some  instances,  by  a  spontaneous  deposite  ;  in  other  cases, 
it  is  in  certain  spots  removed,  so  as  to  leave  a  color  almost  perfectly 
white,  or  that  only  of  the  cutis  vera.4  When  the  latter  change  occurs 

1  Journal  de  Physique,  May,  1819.     Journal  Complementaire,  vol.  v. 
»  J.  Cloquet,  Anat.  da  PHomme,  pi.  cxvi.  fig.  6. 
3  Amer.  Journ.  of  Med.  Science,  Jan.  1845,  p.  245. 

*  A  case  of  this  kind  is  now  in  the  Philadelphia  Almshouse,  where  the  absorption  of 
color  has  occurred  in  spots  on  the  hands  of  a  dark-complexioned  European.  June  15, 1826. 


RETE  MUCOSUM.  333 

in  the  African,  it  occasions  a  hideous  piebald  complexion,  and  the  cuticle 
is  readily  elevated  into  blisters,  by  the  irritation  of  the  solar  rays. 
Some  persons  have  an  entire  deficiency  of  pigment  in  the  rete  mucosum, 
from  birth ;  the  same  deficiency  occurs  in  the  eyes,  and  hair ;  they  are 
designated  as  albinos.  The  same  deficiency  of  pigment  matter  on  the 
palms  and  soles  makes  in  every  black  person  those  portions  of  the 
skin  white.  The  deficiency  of  the  pigmentum  nigrum  in  the  eye 
causes  it  to  look  red,  like  that  of  the  white  rabbit ;  and  also  makes  it 
intolerant  of  a  strong  light,  as  that  of  noonday. 

The  pigment  of  the  rete  mucosum  would  seem,  for  the  foregoing 
reasons,  to  be  continually  undergoing  a  deposition  and  absorption. 
When  it  has  been  lost  by  a  blister  in  an  African,  it  is  generally  restored 
in  a  short  time  afterwards :  the  same  occurs  in  their  cicatrices,  but 
requires  a  longer  period.  The  observations  of  chemists  tend  to  prove 
that  it  is  formed  principally  by  carbon.  Its  apparent  use  is  to  defend 
the  skin  from  the  rays  of  the  sun,  in  illustration  of  which  several  inge- 
nious experiments  have  been  executed  by  Sir  Everard  Home.1 

The  influence  of  the  continued  use  of  nitrate  of  silver  in  giving  a 
leaden  color  to  the  skin  is  well  known. 

Anatomists  generally  have  rejected  the  idea  of  the  essential  vascu- 
larity  of  the  rete  mucosum,  yet  it  wo\ild  aeem  to  have  been  injected, 
on  one  occasion  at  least,  by  the  late  Dr.  Baynham,  in  a  leg  which  was 
diseased  from  exostosis  ;2  and  there  are  now  in  the  anatomical  cabinet 
of  the  University  three  preparations  by  myself  of  the  fingers  of  an 
African,  where  the  coloring  matter  of  the  injection  has  been  passed 
from  the  papillae  of  the  cutis  vera  into  the  rete  mucosum,  and  there 
deposited  in  dots,  indicating  the  former  position  of  the  papillae. 

The  Rete  Mucosum  is  considered  to  be  a  freshly  secreted  layer,  from 
the  cutis  vera,  which,  finally,  becomes  cuticle  by  its  passing  outward 
and  becoming  condensed  and  dried.  The  observations  of  Henle  go  to 
show  that  it  is  constructed  of  minute  oval  cells,  having  each  a  central 
nucleus,  and  as  they  advance  to  the  surface  so  as  to  become  cuticle,  they 
change  their  form  into  flattened  scales. 

Messrs.  Breschet  and  Vauzejme3  also  limit  the  number  of  cutaneous 
layers  to  two,  the  cutis  vera,  and  what  they  call  the  corneous  tissue  or 
epidermic  layers,  which  mean  the  rete  mucosum  and  the  cuticle  of 
anatomists  generally.  These  two,  they  say,  are  a  secretion  of  an  ap- 
paratus in  the  thickness  of  the  skin,  and  which  they  call  blennogenous, 
from  its  product,  a  mucus,  which  finally  inspissates  so  as  to  form  the 
rete  mucosum  and  the  cuticle.  This  apparatus,  or  parenchyma,  is 
furnished  with  short  secretory  canals  which  deposit  the  mucus  between 
the  bases  of  the  papillae  tactus. 

There  is  also,  they  assert,  a  glandular  apparatus  which  they  call 
chromatogenous,  and  furnished  with  ducts,  it  being  likewise  in  the 
thickness  of  the  cutis  vera  and  discharging  on  its  surface.  The  office 

1  Philos.  Transact.,  London,  1821. 

2  Meckel  speaks  familiarly  of  its  being  furnished  with  an  innumerable  quantity  of  capil- 
lary vessels.     Vol.  i.  p.  470. 

3  Nouvelles  Recherches  sur  la  Structure  de  la  Peau,  par  G.  H.  Breschet  et  Roussel  de  Vau- 
zeme,  Paris,  1835. 


334 


INTEGUMENTS. 


of  it  is  to  secrete  the  colored  matter  of  the  rete  mucosum.  hence  its 
name.  But  its  function  is  also  the  secretion  of  the  more  solid  parts  of 
the  corneous  layer,  as  the  epidermis  with  its  extensions  in  the  form  of 
scales,  horns,  spines,  nails,  hoofs,  hair,  wool,  &c. 

M.  Breschet,  in  addition,  alleges  the  existence  of  a  distinct  absorb- 
ing apparatus  in  the  rete  mucosum,  commencing  immediately  under  the 
superficies  of  the  cuticle  and  collecting  its  branches  to  terminate  in  the 
lymphatics  of  the  skin :  he  does  not  claim  to  have  seen  their  mouths. 

The  state  of  microscopical  anatomy,  at  the  present  day,  is  to 
identify  the  rete  mucosum  with  the  cuticle,  by  viewing  it  as  the 
first  development  of  the  cuticle.  It  is  there  in  the  form  of  nuclei, 
in  various  stages  of  growth  into  cells,  and  held  together  by  a  tenacious 
semi-fluid  substance.  More  interiorly,  these  cells  are  nearly  spherical; 
farther  out  they  become,  by  reciprocal  pressure,  polygonal,  and  then 
flattened  as  they  pass  on  to  form  the  real  cuticle. 

There  are  certain  elementary  changes  worthy  of  notice,  marking 
the  distinction  of  the  internal  from  the  external  cells.  The  former 
contain  an  opaque,  soft,  granular  matter,  and  are  with  their  contents 
soluble  in  acetic  acid ;  while  the  latter  become  transparent,  hard,  lose 
their  nuclei,  are  not  soluble  in  acetic  acid,  and  are  converted  into  a 
sort  of  horny  matter,  by  a  change  or  deposit  of  this  material  within 
their  parietes. 

The  color  of  the  rete  mucosum  is  constituted  by  a  quantity  of  what 
are  called  Pigment  cells,  intermixed  with  the  others,  and  which  make 
the  same  transition  from  the  cutis  vera  to  the  surface.  They  are  seen 
with  difficulty  in  the  white  subject,  but  easily  in  the  colored  races :  but 
the  choroid  coat  of  the  eye  in  all  races  exhibits  them  most  freely  and 
beautifully.  They  each  have  a  nucleus,  and  present  an  accumulation 
within,  of  numerous  rounded  or  oval  granules,  measuring  each  the 
°f  an  incn  m  diameter.  What  is  remarkable  about  these  granules, 

Fig.  106. 


Pigment  Cells,  magnified  three  hundred  diameters. — a.  Cell.    b.  Nucleus. 

is,  that  when  examined  separately,  they  are  found  to  be  transparent, 
and  not  black  and  opaque — and  also  exhibit  an  active  movement.  This 
black  pigment  contains  nearly  sixty  per  cent,  of  Carbon.1  Light  would 
seem  to  be  the  motive  for  this  pigment,  which  is  introduced  as  a  pro- 
tection to  the  delicate  cutis  vera,  in  the  different  races  of  human  beings, 
in  a  proportion  harmonizing  closely  with  their  locality  on  the  surface 
of  the  earth,  and  with  the  delicacy  of  texture  of  the  cutis  vera  itself. 
If  the  distinction  heretofore  admitted,  between  the  Rete  Mucosum 
and  the  Cuticle,  is  to  be  abolished,  then,  of  course,  the  expositions  of 
Gaultier  and  of  Dutrochet,  above  recited,  are  to  be  qualified  also.  But, 

1  Carpenter,  Elem.  of  Physiol.  p.  147. 


CUTICLE.  335 

at  the  same  time,  much  difficulty  will  arise  to  the  practical  anatomist 
in  accounting  for  the  succession  of  distinct  laminae  of  the  rete  mucosum, 
exhibited  sometimes  by  blistering,  and  in  preparations  (of  which  we 
have  some  in  the  Anatomical  Museum),  where  the  delimitation  of  layers 
is  as  well  marked  between  the  rete  mucosum  and  cuticle,  as  between 
a  coat  sleeve  and  its  lining.  The  preservation  of  this  distinction  need 
not  affect  the  question  of  both  being  derived  from  the  cutis  vera  in  the 
first  instance. 

It  appears  to  me  evident  that  the  division  into  rete  mucosum  and 
into  cuticle,  with  the  admission  that  the  latter  is  a  modified  exterior 
layer  of  the  rete  mucosum,  is  at  any  rate  almost  indispensable  to  clear- 
ness in  arranging  the  facts  connected  with  the  two :  unquestionably 
there  are,  at  present,  many  existing  anatomical  divisions  upon  lighter 
grounds. 

Another  suggestion  may  also  be  made,  which  is,  that  as  the  rete 
mucosum  is  the  basement  layer,  so  its  name  ought  to  be  retained,  and 
that  of  cuticle  suppressed. 

In  some  very  remarkable  instances,  the  skin  changes  suddenly  black. 
"  We  have  read  to  the  Medical  Society  of  the  Faculty  the  history  of 
a  woman  whose  skin  became  black  in  the  period  of  a  night,  in  conse- 
quence of  a  strong  moral  impression.  This  woman  had  seen  her  daugh- 
ter throw  herself  out  of  the  window  with  her  two  little  children  ;  and  we 
have  since  had  occasion  to  see,  also,  a  woman,  who,  having  escaped 
capital  punishment,  in  the  revolution,  had  experienced  the  same  acci- 
dent. The  latter  was  at  the  period  of  menstruation  when  she  learned 
this  news.  The  menses  were  immediately  suppressed,  and  from  white, 
which  she  was,  she  became  as  black  as  a  negress,  which  color  continued 
on  to  her  death.  We  dissected  with  care  the  skin  of  these  two 
women,  and  found  the  colored  portion  to  be  the  rete  mucosum.  It  was 
sufficiently  easy  to  isolate  the  epidermis  and  the  dermis,  which  pre- 
sented no  abnormal  coloration.  This  black  color  must  be  the/esult  of 
a  sanguineous  exhalation  which  operates  upon  the  rete  mucosum." 

"  The  violet  tinge  of  the  skin  is,  ordinarily,  the  result  of  embarrassed 
circulation.  The  skin  becomes  blue  in  many  very  advanced  diseases 
of  the  heart.  The  name  of  Cyanosis,  or  blue  disease,  has  been  given 
to  this  color  of  the  skin,  which  is  falsely  attributed  to  an  immediate 
communication  of  the  auricles  by  means  of  the  unobliterated  foramen 
ovale.  This  cause  of  the  cyanosis  is  much  more  rare  than  is  commonly 
supposed.''1 


SECT.  III. — OF  THE  CUTICLE  (CUTICULA). 

The  Cuticle  or  Epidermis,  which,  as  just  stated,  is  a  modified  free 
surface  to  the  rete  mucosum,  is  the  most  superficial  portion  of  the  der- 
moid  covering,  and  takes  its  wrinkles  from  the  closeness  of  its  appli- 
cation to  the  true  skin.  It  is  a  thin,  dry  pellicle,  which  cannot  be 
separated  from  the  cutis  by  dissection ;  in  consequence  of  which  we 
have  to  resort  to  the  alternate  application  of  hot  and  cold  water ;  to 

1  Cours  de  Medecine  Ciinique,  par  Leon  Rostan,  Paris,  1830. 


336 


INTEGUMENTS. 


partial  putrefaction;  or  in  the  living  body  to  vesicatories.  The  adhe- 
sion between  the  cuticle  and  the  true  skin  is  through  the  intervention 
of  the  rete  mucosum,  which  being  the  matrix  of  the  cuticle,  and  making 
a  uniform  adhesion  to  the  cutis  vera,  establishes  of  course  the  same 
uniformity  for  the  cuticle  itself. 

In  most  parts  of  the  body  the  cuticle  or  the  outer  face  of  the  Epi- 
dermic layer  presents  itself  of  a  thickness  uniformly  about  that  of 
the  thinnest  Chinese  blotting  paper.  Upon  the  palms  and  soles  of 
persons  generally,  but  especially  of  such  as  are  subjected  to  heavy 
labor,  and  exposed  to  a  continued  mechanical  irritation  of  these  parts, 
the  cuticle  becomes  much  thickened  and  laminated,  obviously  from  a 
successive  deposit  of  it  on  the  cutis  vera.  It  is  transparent,  by  which 
the  color  of  the  parts  beneath  is  readily  discernible;  in  the  African, 
however,  it  is  extremely  difficult,  nay,  impossible  to  clean  it  wholly  of 
the  coloring  matter  of  the  rete  mucosum. 

The  structure  of  this  body  is  as  follows :  The  cuticle  consists  of 
several  successive  layers  of  compressed  cells,  originally  derived,  as 
stated,  from  the  cutis  vera  by  the  intermediate  transition  into  rete  mu- 
cosum. These  cells,  finally  becoming  scales  of  more  and  more  density 
as  they  are  nearer  the  superficies,  are  continually  lost  by  desqua- 
mation  and  supplied  by  a  new  secretion  advancing  through  all  the  in- 
termediate gradations.  Originally  of  a  spheroidal  shape,  as  mentioned 
above,  they  become  more  and  more  compressed,  until  they  are  finally 
flat  planes,  or  nearly  so,  with  no  trace  of  a  central  nucleus.  The  epi- 
dermis is  absolutely  uninterrupted  on  the  surface  of  the  body,  so  that 
it  is  visibly  extended  even  over  the  cornea,  where  it  presents  one  of  the 
best  examples  for  the  microscope,  of  the  scaly  arrangement. 

From  the  epidermis  having  in  itself  no  power  of  regeneration,  owing 
to  its  deficient  organization,  the  most  plausible  opinion  in  regard  to  its 
source  is  the  above.  As  the  external  layer  of  the  rete  mucosum,  it 
undergoes  there  an  inspissation,  and  some  modification  which  render  it 


Fig.  107. 


Fig.  108. 


Fig.  109. 


V*  O>' 

Fig.  107.  Oblique  section  of  Epidermis,  to  show  the  successive  development  of  its  component  cells. 
a.  Nuclei,  upon  the  outer  surface  of  the  cutis  vera  /:  the  nuclei  are  found  to  be  gradually  developed 
into  cells,  at  b,  c,  and  d:  and  the  cells,  being  flattened  into  lamella?,  form  the  exterior  portion  of  the 
epidermis  ate. 

Fig.  108.  Scales  detached  from  the  Epithelium  of  the  Tongue,  magnified  three  hundred  diameters. 
a.  Scale.  6.  Nucleus,  e.  Globule  of  fat  attached  by  accident. 

Fig  109.  Molecules  of  Pigment,  contained  in  pigment  cells,  magnified  five  hundred  diameters. 


CUTICLE.  337 

a  sort  of  varnish,  well  qualified  to  resist  the  agency  of  exterior  objects, 
and  to  protect  the  delicate  organization  of  the  proximate  surface  of  the 
cutis  vera.  This  opinion  of  its  origin  seems  to  be  adequately  proved 
by  its  participating  in  the  color  of  the  rete  mucosum,  more  or  less,  so 
as  to  give  it  a  sensible  tinge,  which  cannot  be  washed  from  it. 

There  is  no  evidence  whatever  of  the  existence  of  vessels  in  it:  on 
the  contrary,  in  inflammations,  when  the  skin  becomes  of  the  deepest 
tinge  of  red,  the  epidermis  never  has  its  color  changed  in  the  smallest 
degree;  the  impression  made  on  it  is  only  manifested  by  its  dropping 
off,  while  another  layer  is  preparing  to  take  its  place. 

A  fine  injection,  when  forcibly  driven  into  the  extremities  of  a  fetus, 
will  become  extravasated  between  the  cutis  vera  and  cuticle,  and  raise 
up  the  latter  in  small  blisters,  as  I  have  frequently  experienced,  though 
it  cannot  be  caused  to  pass  through  the  cuticle. 

Neither  nerves  nor  cellular  membrane  exist  in  this  tissue ;  it  has  not 
the  slightest  sensibility,  neither  is  this  quality  evolved  by  any  condi- 
tion whatever,  as  it  is  in  tendons,  ligaments,  and  bones,  when  th'ey  be- 
come inflamed.  The  excrescences  which  belong  to  it,  as  corns  and 
indurations,  are,  like  it,  laminated,  owing  to  their  thickness,  and  have 
no  interior  circulation;  and  though  sometimes  painful,  are  so  only  by 
their  pressing  upon  the  subjacent  nerves  of  the  skin.  They  are  to  be 
viewed  as  a  morbid,  or  abnormal  production  of  the  cutis  vera,  taking 
the  place  of  regular  cuticle.  It  is  also  destitute  of  filaments. 

The  cuticle  is  penetrated  by  hairs,  and  by  the  orifices  of  the  sudori- 
ferous and  sebaceous  follicles  and  glands;  and  according  to  Bichat, 
also,  by  the  exhalants  and  absorbents,  the  several  orifices  of  which,  he 
says,  become  distinct  by  holding  it  between  the  eye  and  a  strong  light. 
As  it,  when  raised  by  a  bjister,  does  not  allow  the  effused  fluid  to  pass 
through  any  of  these  pores,  it  is  very  reasonably  supposed  that  they 
are  all  oblique,  and,  therefore,  exercise  a  valvular  office  on  such  an  oc- 
casion. Or  if,  according  to  the  original  supposition  of  Mr.  Cruikshank, 
now  sufficiently  verified  by  the  microscope,  the  finest  pores  of  the  cutis 
vera  are  lined  by  processes  from  the  cuticle,  the  collapse  of  these  pro- 
cesses on  the  separation  of  the  cuticle  will  also  account  for  the  fact. 
It  seems  to  be  well  ascertained,  at  the  present  time,  that  as  the  epider- 
mis is  more  transparent  at  certain  points  than  elsewhere,  the  appear- 
ance has  been  mistaken  for  porosities  of  exhalants  and  absorbents. 
The  cuticle,  when  detached,  will  not  allow  a  column  of  mercury  to  pass 
through  it,  except  its  weight  be  so  great  as  to  lacerate  it :  this  fact  is 
rather  against  the  doctrine  of  pores  being  visible  when  examined  by 
permitting  the  light  to  shine  through,  and  shows  that  even  those  for 
the  hairs  and  the  sebaceous  follicles  are  stopped  by  some  arrangement 
or  other. 

The  cuticle  has  but  little  power  of  extension,  and,  consequently,  of 
contraction,  and  tears  with  the  application  of  a  very  slight  force.  It 
naturally  contains  so  little  moisture,  that  its  bulk  is  only  inconsiderably 
altered  by  drying.  It,  like  the  hair  or  nails,  resists  putrefaction  so 
much,  that  it  has  been  found  in  burial  places  after  a  lapse  of  fifty  years. 
When  held  in  water,  it  swells,  becomes  white,  wrinkles  more,  loses  its 
transparency,  and  dulls  the  sensibility  of  the  cutaneous  papillae.  It 
cannot,  like  the  true  skin,  be  readily  reduced,  by  boiling  water,  into 
VOL.  I.— 22 


338  INTEGUMENTS. 

gelatin,  and,  consequently,  is  not  affected  by  tanning :  it,  indeed,  re- 
tards that  process,  when  left  on  the  proximate  surface  of  the  cutis 
vera.  When  applied  to  a  fire,  it  burns  like  the  hair  and  nails,  with 
extreme  facility,  owing  to  the  presence  of  a  similar  oil  in  it,  and  it 
gives  out  a  very  disagreeable  odor. 

The  little  extensibility  of  the  cuticle  causes  it  to  be  ruptured  when- 
ever tumors,  as  warts,  &c.,  rise  from  the  surface  of  the  cutis  vera:  it 
is  supposed,  however,  not  to  be  entirely  deprived  of  this  quality,  as  it 
seems  to  stretch  when  raised  into  a  blister,  though  this  may  come,  in 
some  measure,  from  the  small  wrinkles  naturally  existing  in  it  being 
drawn  out. 

That  a  loss  and  reproduction  of  the  cuticle  are  constantly  going  on  is 
manifested  by  the  large  quantity  of  branny  scales  that  are  detached 
from  its  surface,  when  one  has  abstained  from  bathing  for  a  long  time. 
This  is  more  remarkable  on  the  palms  and  soles  than  elsewhere,  and 
the  loss  must  of  course  be  continually  supplied.  It,  as  is  well  known, 
is  rapidly  regenerated  when  it  has  been  lost  simply  by  an  abrasion  or 
blistering,  which  has  not  interfered  with  the  organization  of  the  rete 
mucosum.  In  some  cases  there  is  an  unusual  development  of  it. 
Bichat  retained  the  skin  of  a  patient,  dead  at  the  Hotel  Dieu,  in 
whom  the  cuticle,  at  the  period  of  birth  and  in  subsequent  life,  was 
three  times  the  natural  thickness ;  and  had  always,  with  the  exception 
of  that  of  the  face,  been  subject  to  a  continual  desquamation. 

One  of  the  most  striking  properties  of  the  cuticle  is  its  resistance 
to  evaporation  from  the  surface  of  the  body:  in  a  subject,  any  part  of 
the  derm,  when  deprived  of  it  and  exposed  to  the  air,  dries  up  in  the 
course  of  a  day  or  two ;  while  the  other  portions  remain  soft  and  flexi- 
ble for  weeks,  and,  if  it  were  not  for  putrefaction  causing  the  cuticle 
to  peel  off,  would  sometimes  remain  so  for  months.  Though  it  sup- 
presses evaporation,  in  a  great  measure,  it  does  not  do  so  entirely ;  for, 
after  a  subject  has  been  kept  some  time,  its  fingers,  toes,  nose,  and 
ears  get  very  dry  and  hard. 

The  power  of  the  cuticle  to  absorb  or  to  transmit  inwardly  articles 
through  it  is  not  by  any  means  so  obvious  as  its  exhalation :  the  facts, 
however,  upon  the  whole,  seem  to  prove  that  though  this  power  is  much 
curtailed  when  compared  with  that  possessed  by  mucous  surfaces,  yet 
it  does  exist  to  a  certain  extent.1 


CHAPTER  II. 

OF  THE  SEBACEOUS,  PERSPIRATORY,  AND  ODORIFEROUS  ORGANS 

OF  THE  SKIN. 

THE  Sebaceous  Organs  consist  in  Follicles  (cryptse  mucosse)  and 
Glands  (glandulse  sebacese). 

The  Sebaceous  Follicles,  probably  according  to  the  suggestion  of  M. 

1  Wistar's  Anat.  vol.  ii.  p.  396,  3d  edit. 


THE  SEBACEOUS  ORGANS.  330 

Beclard,  exist  over  the  whole  surface  of  the  skin,  with  the  exception  of 
the  palms  and  soles ;  because  the  skin  is  universally  rendered  unctuous 
by  a  discharge ;  because  many  follicles  exist,  which  are  only  visible  to 
the  microscope ;  and  because  morbid  changes  frequently  render  them 
evident,  where  their  existence  was  not  suspected  before.  In  many 
places  these  follicles  are  sufficiently  obvious  and  very  numerous,  as  on 
the  nose,  about  the  corners  of  the  mouth,  on  the  ear  and  behind  it, 
and  on  the  entire  face,  of  some  individuals.  They  consist  of  small 
pouches  like  inflections  of  the  surface  of  the  true  skin  placed  in  its 
thickness,  and  when  it  has  been  injected,  are  seen  to  have  their  parietes 
abundantly  furnished  with  blood-vessels. 

The  discharge  from  them  sometimes  becomes  inspissated,  and  does 
not  readily  pass  through  their  orifices;  in  which  case,  continuing  to 
accumulate,  it,  with  the  epithelial  cells  lining  them,  will,  finally,  form 
a  sensible  tumor.  Most  frequently  it  does  not  collect  to  such  an  ex- 
tent, but  is  indicated  simply  by  a  small  black  point,  owing  to  the  adhe- 
sion of  dirt  to  it :  in  this  condition,  when  squeezed  out,  it  assumes  a 
small  vermicular  shape. 

The  sebaceous  follicles  are  said  by  Mr.  Erasmus  Wilson  to  be  the 
residence  in  great  numbers  of  a  curious  parasite,  the  Demodex  Follicu- 
lorum.  The  inhabitants  of  large  towns  are  especially  the  subjects  of 
this  condition.1 

The  Sebaceous  Crlands,  properly  speaking,  are  about  the  size  of  a 
millet  seed,  of  a  light  yellow  color,  and  are  placed,  wherever  they 
exist,  immediately  under  or  near  the  cutis  vera.  They  are  particularly 
numerous  under  the  skin  .of  the  mons  veneris.  The  latter  glands  may, 
however,  possibly  belong  to  the  same  order  with  the  miliary  glands 
just  under  the  skin  of  the  axilla,  and  presently  to  be  noticed. 

The  sebaceous  glands  are  a  more  complex  arrangement  of  the  sim- 
ple follicular  excavations,  and  consist  of  groups  of  the  latter  resem- 
bling in  shape  a  blackberry,  each  cell  being  distinct,  but  all  discharg- 
ing into  a  common  duct.  Sometimes  they  are  laid  down  in  the  form 
of  a  long  tube  with  side  cells  or  canals  entering  into  it;  the  Meibo- 
mian  glands  of  the  eyelids  are  of  this  description. 

Where  the  hair  is  abundant,  as  on  the  head,  chin,  mons  veneris,  &c., 
the  ducts  of  the  sebaceous  glands  discharge  to  a  large  extent  into  the 
sac  containing  the  hair. 

The  sebaceous  organs  furnish  the  oily  exhalation,  which  lubricates 
the  surface  of  the  skin,  gives  linen,  when  worn  a  long  time,  a  greasy 
appearance,  and  causes  the  water  in  which  we  bathe  to  assemble  in 
drops,  on  the  surface  of  the  body,  rather  than  to  wet  it  uniformly. 
This  humor  produces  a  rancid  disagreeable  smell  from  the  surface  of 
such  persons  as  do  not  resort  to  ablutions  of  the  whole  skin,  from  time 
to  time.  It  is  particularly  abundant  about  the  places  provided  with 
hairs,  as  the  scalp,  the  genital  organs,  the  axillae,  and  seems  to  be  in- 
tended to  maintain  the  flexibility  and  smoothness  of  the  skin  and  hair, 


1  Carpenter's  Elements  of  Physiol.  p.  428,  Phil.  1846. 


340  INTEGUMENTS. 

and  to  prevent  the  former  from  chapping.  These  qualities  of  it  are 
possessed,  in  a  considerable  degree,  by  the  oily  articles  of  the  toilet, 
•which  are  used  for  the  same  purpose.  There  can  be  no  doubt  of  the 
oily  quality  of  this  secretion,  as,  when  collected  on  a  piece  of  clothing 
or  on  blotting-paper,  it  burns  with  a  white  flame.  Its  quantity  is 
readily  augmented  by  certain  kinds  of  clothing,  which  most  persons 
must  have  observed  shortly  after  putting  on  a  flannel  shirt  next  to  the 
skin. 

It  is  sufficiently  certain  that  the  apparatus  producing  this  oil  is  not 
visible  to  the  naked  eye  in  most  parts  of  the  skin,  so  that  there  would 
seem  to  be  some  necessity  of  accounting  for  its  appearance  there, 
either  according  to  the  suggestion  of  Mr.  Beclard  as  above,  or  in  some 
other  way  besides  that  of  evident  glandular  bodies.  Bichat  considered 
it  to  arise  from  a  set  of  exhalants  differing  from  those  which  secrete 
the  matter  of  perspiration,  a  theory  far  more  rational  than  that  which 
attributes  it  to  the  percolation  of  the  subcutaneous  fatty  matter. 

The  Perspiratory  Organs.1 — The  perspiration  is  the  product  of  cer- 
tain bodies  called  the  Sudoriparous  glands,  investigated  particularly  by 
Gur.lt.  They  are  contained  in  the  substance  of  the  cutis  vera,  but  pro- 
ject also  into  the  subcutaneous  cellular  tissue.  These  glands  are  re- 
markable for  consisting  of  a  cylindrical  tube  generally,  which  extends 
itself  from  the  under  surface  of  the  true  skin  to  the  surface  of  the 
cuticle.  In  the  first  part  the  tube  is  tortuous  and  collected  into  a 

Fig.  no. 


A  magnified  view  of  the  Sudoriferous  Organs  of  the  Skin  on  the  Sole  of  the  Foot. — 1, 1.  The  salient 
lines  of  the  external  surface  of  the  skin  cut  perpendicularly.  2,  2.  The  furrows  or  wrinkles  of  the  same. 
3.  The  epidermis  or  cuticle,  as  formed  by  its  superimposed  layers.  4,4.  The  rete  mucosum.  5, 5.  The 
cutis  vera,  with  its  cellular  fibres  pressed  into  fasciculi  and  each  directed  towards  the  papillae.  6,  6. 
The  papillae,  each  of  which  answers  to  the  prominences  on  the  external  surface  of  the  skin.  7.  The 
small  furrows  between  the  papillae.  8.  The  deeper  furrows  which  are  between  each  couple  of  the 
papillae.  9.  Cells  filled  with  fat,  and  seen  between  the  bands  of  fibres.  10.  The  adipose  layer,  with 
numerous  fat  vesicles.  11.  Cellular  fibres  of  the  adipose  tissue,  continuous  with  the  subcutaneous 
cellular  tissue,  and  with  that  of  the  cutis  vera.  12.  The  sudoriferous  follicles.  13.  The  spiral  or  su- 
doriferous canals.  14.  The  infundibular-shaped  pores  or  orifices  of  these  canals. 

1  Gerber,  p.  143. 


THE  SEBACEOUS  ORGANS.  341 

spherical  ball  of  about  one-sixth  of  a  line  in  diameter,  surrounded  by 
fat  vesicles.  As  the  tube  then  proceeds  through  the  meshes  of  the 
corium,  or  cutis  vera,  it  bends  right  and  left  to  pass  from  the  deeper 
to  the  more  superficial  layers.  Having  reached  the  rete  mucosum  and 
the  cuticle,  it  then  adopts  a  spiral  direction,  the  turns  being  very  short, 
as  seen  in  the  filaments  attaching  the  cutis  vera  and  cuticle  when  they 
are  loosened  by  maceration.  The  tube  then  opens  by  a  conical  orifice 
upon  the  ridges  of  the  cutis  vera  made  by  the  papillae  tactus,  the 
ridges  at  these  places  being  intersected  by  transverse  furrows  between 
the  papillae.  The  orifice  of  the  sweat  duct  is  lined  to  some  distance 
by  the  cuticle,  which  is  sometimes  drawn  out  from  it  as  a  short  duct 
or  process. 

These  glands  are  of  a  reddish  color,  semi-transparent,  and  are  found 
with  most  ease  on  the  palms  of  the  hands,  and  on  the  soles  of  the  feet, 
according  to  Gurlt. 

The  estimate  of  Krause  is,  that  there  are  on  an  average  one  thou- 
sand orifices  of  sweat  glands  over  every  one  inch  square  of  the  sur- 
face of  the  human  body.  The  largest  numbers  being  on  the  sole  and 
palm,  and  amounting  to  about  twenty-seven  hundred — and  the  smallest 
on  the  neck,  back,  and  nates,  and  exceeding  somewhat  four  hundred; 
on  the  breast,  abdomen,  and  fore  arm  there  are  about  1,100  to  the 
square  inch.  The  entire  number  he  fixes  at  2,381,24s.1 

During  life  the  process  of  perspiration  is  continually  going  on,  either 
in  a  sensible  or  insensible  manner ;  and  according  to  the  experiments 
of  Sanctorius,  more  than  one-half  of  the  weight  of  our  food  is  lost  in 
that  way  through  the  skin  and  lungs.  MM.  Lavoisier  and  Seguin 
ascertained  that  the  proportionate  exhalation  from  these  organs  was 
eleven  of  the  former  to  two  of  the  latter.  When  the  perspiration  is 
rapid,  it  assembles  on  the  surface  of  the  body  in  the  form  of  small 
drops,  having  an  acid,  saltish  taste,  and  a  peculiar  odor.  In  this 
state,  according  to  the  analysis  of  Berzelius,  it  consists  principally  in 
water,  holding  in  solution  a  hydrochlorate  of  soda  and  of  potash,  some 
lactic  acid,  lactate  of  soda,  and  a  little  animal  matter.  The  perspira- 
tion, besides  its  use  as  an  excretion,  is  a  powerful  means,  by  its  evapo- 
ration, of  enabling  the  body  to  resist  a  high  temperature.  It  varies, 
both  in  quality  and  quantity,  according  to  age,  sex,  state  of  health, 
foodj  and  habits  of  life. 

Dr.  W.  Hunter,  though  he  disbelieved  in  the  possibility  of  injecting 
the  cuticle?  and  did  not  admit  the  evidence  of  the  preparations  of  his 
time  having  that  reputation;  yet  thought  the  communicating  or  per- 
spiratory vessels  might  be  exhibited  in  a  different  manner,  that  is,  by 
macerating  for  a  short  time  a  piece  of  the  sole  of  the  foot:  afterwards, 
in  separating  the  cuticle  from  the  cutis  vera,  as  the  two  membranes 
parted,  these  vessels  would  be  found  in  the  angle  of  separation  pass- 
ing from  one  to  the  other  like  cobweb  filaments.2 

There  can  be  no  doubt  of  this  appearance,  for  it  is  easily  verified  by 
any  one  who  will  take  the  trouble  to  perform  the  experiment.  M. 
Be'clard  has  erroneously  suggested,  that  these  filaments  are  merely  the 


1  Mullet's  Archives,  1844. 

2  Med.  Obs.  and  Inquiries,  vol.  ii.  p.  53,  London,  1762. 


342 


INTEGUMENTS. 


threads  formed  out  of  the  rete  mucosum,  which  is  rendered  a  viscous 
fluid  by  the  commencement  of  putrefaction ;  and,  therefore,  when  parted, 
will  put  on  the  same  filamentous  appearance  that  half  dissolved  glue 
does  in  a  similar  situation.  Some  of  the  aforesaid  filaments  also  are 
supposed  by  Bichat  and  Chaussier  to  be  absorbents. 

The  original  sentiment  of  Dr.  Wm.  Hunter  on  the  perspiratory  ves- 
sels, being  in  fact,  the  delicate  filaments  between  the  cuticle  and  cutis 
vera,  seen- on  separating  them,  was  reproduced  by  Gurlt.  The  argu- 
ments against  their  being  the  merely  softened  rete  mucosum,  as  sug- 
gested by  Mr.  Be'clard,  are  their  very  uniform  size,  one  with  another; 
their  spiral  line  of  progress;  and  their  re-appearance  at  the  same  spots 
exactly,  which  could  scarcely  be  the  case,  in  an  inspissated  fluid  drawn 
out  into  strings,  and  then  allowed  to  collect  itself  again  into  a  mass, 
or  layer.  The  process  being  repeated  over  and  over  again  with  these 
filaments,  will  show  them  constantly  returning  to  the  same  condition. 

The  Odoriferous  Glands  (glandulse  odoriferse).  I  have  ventured  to 
give  this  name  to  the  layer  of  well  marked  subcutaneous  glands  placed 
in  the  axilla,  and  which  till  lately  were  too  much  neglected  by  anato- 
mists. They  are  remarkably  well  evolved  and  distinct  in  the  negro, 
though  not  peculiar  to  that  race,  and  are  just  beneath  the  skin  of  the 
arm  pit,  imbedded  in  the  common  adipose  cellular  membrane,  and  in- 
termixed with  the  bulbs  of  the  hairs. 

It  is  well  known  in  our  country  that  the  smell  of  negroes  is  particu- 
larly redolent  from  the  axilla  (the  same  may  be  said  in  a  qualified  way, 
of  persons  of  all  complexions) ;  and  that  some  of  them,  with  the 
strongest  efforts  to  free  themselves  from  it,  are  so  organized  that  they 
may  be  traced  by  the  effluvium  with  which  they  impregnate  the  air. 

Fig.  111. 


The  layer  of  glands  represented  in  the  accompanying  figure  will,  I 
think,  go  largely  towards  an  explanation  of  that  fact,  and  in  doing  so, 


THE  ODORIFEROUS  GLANDS.  343 

they  may  not  be  improperly  called  the  Odoriferous  Glands  of  the 
Axilla.  They  belonged  to  an  almost  coal  black  male  subject,  of  fine 
development  of  skeleton  and  muscle,  not  advanced  in  life,  and  which 
•was  used  for  the  anatomical  lectures.1  The  piece  is  represented  as  it 
stands  suspended  in  a  round  bottle  of  some  sixteen  or  eighteen  ounces, 
and  under  a  magnifying  influence  which  enlarges  the  diameters  about 
one-third. 

From  the  representation  it  will  be  seen  that  these  glands  amount  to 
from  two  hundred  and  fifty  to  three  hundred,  and  make  a  circular  plate 
about  the  size  of  a  large  Spanish  dollar.  In  raising  the  skin  of  the 
axilla,  they  are  found  very  near  it,  and  as  the  skin  there  is  very  thin, 
the  principal  thickness  of  the  tegument  is  derived  from  the  subcuta- 
neous cellular  layer.  These  glands  are  so  invested  and  masked  by  the 
layer,  that  unless  a  special  examination  be  made  for  them  they  are 
almost  certainly  overlooked ;  with  the  attention,  however,  directed  to 
them  they  are  found  with  unerring  certainty ;  and  become  still  more 
conspicuous  by  a  colored  injection  and  by  maceration  in  water,  which 
infiltrates  the  cellular  substance.  They  are  heaped  up  near  the  centre, 
become  more  and  more  scarce  towards  the  circumference,  and  at  the 
latter  have  distant  intervals  between  them,  some  few  being  so  scattered 
as  to  form  the  outposts  of  the  circle. 

These  glands  are  of  a  fuscous  color,  and  vary  in  size,  some  being 
only  the  half  of  a  line  or  less  in  diameter,  and  others  reaching  to  two 
lines.  The  central  ones  are  the  larger.  They  bear  upon  their  surface 
the  granular  aspect  so  common  to  similar  composite  glands,  as  the  labial 
and  buccal,  the  pancreatic  and  the  mammary.  Their  magnitude  is 
too  great  to  suppose  that  they  are  a  simple  appendage  of  the  hairs  of 
the  axilla,  which  indeed  in  this  subject  are  few  and  small :  neither  do 
they  admit  entirely  of  being  placed  in  the  category  of  perspiratory 
glands,  according  to  the  sentiments  of  Krause  and  others. 

These  glands  under  microscopic  examination  are  found  to  have  the 
same  structure  with  the  perspiratory  glands,  presenting  in  fact  a  repe- 
tition of  it,  and  being  therefore  generally  considered  to  be  the  same. 
The  analogy  of  glandular  structure  is  not,  however,  always  a  proof  of 
similar  secretions,  because  the  ceruminous  glands,  for  example,  resemble 
the  sweat  glands,  and  yet  no  one  pretends  that  the  secretion  is  identical. 
Their  size,  granular  appearance  and  inspissated  secretion,  with  its  some- 
what peculiar  odor,  would  imply  some  special  action. 

The  largest  sebaceous  glands  of  the  skin,  as  stated  by  Gerber,2  con- 
sidered now  excellent  authority,  are  the  Meibomian  glands  as  encoun- 
tered on  the  eyelids.  He  also  says,  with  others,3  that  the  sebaceous 
follicles  of  the  skin  "  generally  open  laterally  into  the  hair  sheaths ; 
they  always  occur  isolated,  and  are  not  so  universal  as  the  more  com- 
pound sebaceous  glands."  In  regard  to  the  perspiratory  glands  of 
Gurlt,  the  same  authority  says,4  "that  their  contents  being  watery  and 
uncolored  with  pigmentary  matter,  they  are  highly  transparent,  and 
much  more  difficult  to  discover  and  to  examine  under  the  microscope 
than  the  sebaceous  glands.5' 

1  December,  1844. 

2  Elem.  Gen.  Anat.  p.  142,  London,  1842.  3  Id.  p.  327. 
'        4  Ibid.  p.  144. 


344  INTEGUMENTS. 

The  necessity,  or  rather  probability  of  a  distinct  glandular  apparatus, 
for  the  peculiar  effluvium  of  the  human  skin,  has  been  heretofore  fre- 
quently conjectured.  Thus,  besides  others,  we  have  a  recent  distin- 
guished authority  advancing,  that  it  is  probable  that  by  glands  of 
special  functions  are  elaborated  the  odorous  secretions  which  are  exuded 
from  particular  parts  of  the  surface,  especially  the  axilla.1  The  same 
idea  is  presented  in  the  learned  work  on  Physiology,  by  Prof.  Dun- 
glison,2  in  the  declaration  that  the  sebaceous  follicular  secretions  differ 
materially,  according  to  the  part  of  the  body  where  they  exist,  as  mani- 
fested by  the  varying  fluids  discharged  in  the  axilla,  groins,  feet,  &c. 
The  real  anatomical  views  of  those  gentlemen,  however,  as  well  as  of 
Muller3  and  of  other  physiologists,  do  not  seem  to  go  beyond  the  admis- 
sion of  the  ordinary  sebaceous  cryptae,  and  of  the  sebaceous  glands  in 
connection  with  the  hairs. 

These  glands,  though  much  neglected  for  some  time,  were  better 
known  at  a  former  period.  The  celebrated  Winslow,  Professor  of 
Anatomy  in  the  University  of  Paris,  speaking  of  the  Cutaneous  Glands, 
commonly  called  Glandulae  Miliares,  says,  that  the  under  surface  of 
the  skin  is  covered  by  them,  and  that  they  are  fixed  in  fossulse  common 
to  the  skin  and  subcutaneous  cellular  substance,  and  that  their  excre- 
tory ducts  open  on  the  outer  surface  of  the  skin,  sometimes  on  the 
papillae,  at  others  on  the  side  of  them,  as  may  be  seen  even  without 
a  microscope  in  the  ends  of  the  fingers.  The  greater  part  of  them,  he 
considers  to  furnish  sweat,  and  others  a  fatty  oily  matter,  as  on  the 
scalp,  on  the  back,  behind  the  ears  and  on  the  nose.  He  also  asserts, 
that  by  macerating  the  skin  in  water,  these  miliary  glands  become  more 
visible,  especially  in  the  skin  of  the  lower  part  of  the  nose,  and  in  that 
of  the  axilla.  a  The  late  Mr.  Duverney  (the  master  of  Winslow) 
demonstrated  to  the  Royal  Academy,  that  the  structure  of  some  of  the 
cutaneous  glands  resembles  the  circumvolutions  of  the  small  intestines 
plentifully  stored  with  capillary  vessels."4  These  observations  may  be 
considered  as  the  precursors  of  the  present  state  of  the  glandular 
Anatomy  of  the  skin,  as  designated  by  the  microscopical  Anatomists, 
Gurlt,  Gerber,  Wagner,  Todd  and  Bowman,  and  still  more  recently, 
by  Mr.  Ch.  Rolin,5  before  the  French  Academy  of  Sciences,  who  has 
also  observed  them  in  the  groin,  where  he  considers  them  to  be  less 
abundant  than  in  the  axilla.  But  to  Duverney,  as  above,  may  be 
safely  awarded  the  credit  of  elucidating  the  tortuous  line  of  their  ducts, 
as  in  the  acknowledged  course  of  the  sweat  glands  by  Gurlt,  and  of 
the  ceruminous  by  Wagner. 

1  Principles  of  Human  Physiology,  by  W.  B.  Carpenter,  p.  584,  London,  1842. 

2  P.  95,  vol.  i.  Philadelphia,  1844. 

3  Physiology,  p.  481,  London,  1840. 

4  Anat.  Expos,  of  the  Struct,  of  the  Human  Body,  by  Winslow,  Prof.,  &c.,  translated  by 
Douglass,  vol.  ii.  p.  117,  London,  1749. 

*  See  Am.  Journ.  Med.  Sci.  April,  1846,  p.  435. 


THE  NAILS.  345 


CHAPTER  III. 
OF  THE  NAILS. 

THE  Nails  (ungues)  supply  the  place  of  cuticle  on  the  extremities 
of  the  fingers  and  toes,  and  may  be  considered  as  a  continuation 
of  this  membrane,  because  in  maceration  they  come  off  along  with 
it.  They  correspond  with  the  talons  and  hoofs  of  the  lower  orders  of 
animals. 

Each  nail  consists  of  a  root,  of  a  body,  and  of  a  free  extremity,  or 
that  which  projects  and  requires  paring.  The  root  is  about  one-fifth 

Fig.  112.  .  Fig.  113. 


Fig.  112.  The  Thumb-Nail  detached  from  the  thumb  and  seen  on  its  external  surface,  with  the 
epidermis  of  which  it  is  a  continuation.  1.  Root  of  the  nail  deprived  of  the  derma.  2.  Its  body. 
3.  Its  summit.  4,  4.  The  epidermis  covering  the  sides  of  the  nail.  5.  The  crescent  or  lunula  of  the 
nail. 

Fig.  113.  A  Longitudinnl  Section  of  the  Nail  of  the  Ring  Finger.  1.  The  third  phalanx.  2.  The 
adipose  tissue.  3.  The  skin.  4.  The  root  of  the  nail  and  fold  of  the  skin  in  which  the  root  is  inserted. 
5.  The  cutis  vera  covered  by  the  nail.  6.  The  rete  mucosum.  7.  Root  of  the  nail.  8.  Its  body.  9. 
Its  summit  or  free  end. 

of  the  length  of  the  nail ;  is  thin,  soft,  and  white,  and  is  received  into 
a  fold  or  fossa  of  the  true  skin,  which  is  very  distinct  when  the  cuticle 
and  nail  are  removed  together  by  maceration.  The  concave  surface  of 
the  nail  adheres  closely  to  the  skin  below,  precisely  as  the  cuticle  does 
in  any  other  part  of  the  body,  and  therefore  may  be  loosened  by  the 
same  processes,  as  hot  water  and  maceration.  The  white  part  of  the 
nail,  at  its  root,  is  called  the  Crescent  (lunula),  and  is  said,  by  Mosely,1 
never  to  exist  in  the  fingers  of  Africans  or  of  persons  who  have  even 
a  slight  mixture  of  negro  blood  ;  the  latter  opinion  I  am  disposed  to 
consider  incorrect.  This  appearance,  however,  does  not  depend  upon 
any  peculiar  organization  of  the  nail  itself  at  that  part,  but  upon  the 
cutis  vera  below  it,  which,  being  more  vascular  elsewhere,  causes  that 
spot  to  look  white,  the  nail  being  semi-diaphanous  and  permitting  a 
view  of  the  circulation  beneath.  This  is  also  sufficiently  proved  by  the 
fact  that  when  a  nail  is  torn  off,  its  lunula  disappears.  The  nail 
increases  gradually  in  thickness  from  its  root  to  its  free  extremity. 

1  Diseases  of  Warm  Climates. 


346  INTEGUMENTS. 

The  nail  is  covered  on  the  posterior  face  of  its  root,  by  the  epidermis, 
which  terminates  there  in  a  thin,  adherent,  diaphanous  band :  behind 
this  band  the  root  of  the  nail  projects,  and  is  received  into  the  groove 
of  the  cutis  vera.  The  epidermis  also  adheres  to  the  lateral  margin  of 
the  nail,  and  in  a  curved  line,  to  the  concave  side  of  its  anterior  end. 
The  under  surface  of  the  nail  is  soft,  pulpy,  and  has  an  arrangement 
of  superficial  longitudinal  grooves,  receiving  the  papillae  and  ridges  of 
the  corresponding  surface  of  the  cutis  vera.  As  the  black  color  of  the 
negroes  is  sometimes  seen  beneath  their  nails,  it  is  probable,  as  stated, 
that  the  rete  mucosum  exists  there  also ;  but  it  is  not  so  clearly  ascer- 
tained, though  the  observations  of  M.  Gaultier,  on  the  rete  mucosum 
of  animals,  tend  to  prove  it.1 

As  the  nails  are  entirely  destitute  of  organization,  having  neither 
vessels  nor  nerves,  they  have  no  power  of  growth  nor  of  disease  in 
themselves,  these  qualities  being  derived  exclusively  from  the  cutis  vera. 
The  materials  of  their  formation  are,  accordingly,  secreted  from  the 
cutis  vera,  in  the  bottom  of  the  groove,  formed  by  the  latter  for  the 
reception  of  their  root.  As  these  materials  adhere  to  the  preceding 
formation,  and  become  concrete,  by  adding  continually  to  its  length, 
they  shove  it  forward,  and  thereby  elongate  it.  While  this  is  going  on 
in  the  groove,  the  thickness  of  the  nail  is  also  somewhat  increased  by 
an  excretion  from  the  skin  contiguous  to  its  concave  surface.  This 
accounts  for  the  nail  being  thicker  at  its  free  extremity  than  at  its  root. 

The  skin,  where  it  is  in  connection  with  the  nail,  is  called  its  matrix, 
and  exhibits  numerous  longitudinal  fine  ridges  which  make  corre- 
sponding furrows  into  the  nail ;  there  are  also  small  papillary  projec- 
tions. The  end  of  the  nail  at  its  root  is  also  finely  serrated,  and  the 
interspaces  are  filled  with  corresponding  filiform  papillae  arising  from 
the  skin.  These  papillae  are  the  sources  of  the  growth  of  the  nail  by 
the  continual  secretion  from  them,  and  exhibit  a  close  analogy  with  the 
arrangement  at  the  roots  of  the  hair.  The  microscope  shows  that  the 
original  secretion  is  in  the  condition  of  soft  nucleated  cells,  which  are 
attached  to  their  predecessors^  and  that  this  arrangement  prevails  every- 
where over  the  adherent  surface  of  the  nail.  The  foetal  period  is  the 
best  for  observing  these  nucleated  cells.  As  the  growth  advances  they 
assume  the  consistence  peculiar  to  the  nail. 

Owing  to  a  peculiarly  morbid  state  of  the  proximate  surface  of  the 
true  skin,  it  sometimes  happens,  that  the  contribution  to  the  nail  from 
it  exceeds  that  from  the  groove ;  the  consequence  of  which  is,  that  the 
whole  nail  grows  upwards  like  a  horn,  instead  of  forwards.  An  ex- 
ample of  this  kind  was  several  years  ago  exhibited  to  me  by  Prof. 
Charles  D.  Meigs,  in  a  whfte  female,  aged  about  ninety.  In  this  case 
one  of  the  big  toe  nails  had  grown  upwards,  in  a  semi-spiral  manner, 
to  the  length  of  four  and  a  quarter  inches,  when  measured  along  the 
outer  edge  of  the  spiral.  The  corresponding  nail  of  the  other  side 
would  have  been  of  nearly  the  same  length,  but  it  had  been  broken. 
The  nails  of  all  th*e  other  toes  had  assumed  a  similar  manner  of  growth, 
and  measured  from  one  and  a  half  to  two  inches.  In  the  case  of  each 
nail,  its  anterior  extremity  presented  the  primitive  nail  as  it  had  been 
before  this  extraordinary  hypertrophy. 

1  See  Rete  Mucosum. 


%  THE  HAIR.  347 

The  statement  of  the  patient  was,  that  the  growth  had  commenced 
about  fifteen  years  previously.  A  tendency  to  this  horny  growth  from 
the  skin  was  also  manifested  in  a  tubercle,  three  or  four  lines  long, 
with  an  ulcerated  base,  from  the  back  of  her  nose  ;  and  by  scaly  ex- 
crescences on  the  legs.  The  patient  having  died  shortly  afterwards,, 
the  collection  of  nails  was  politely  presented  to  the  Anatomical  Museum, 
by  Dr.  Meigs. 

I  am  indebted  to  my  friend  Dr.  Theophilus  C.  Dunn,  of  Newport, 
Rhode  Island,  a  graduate  of  this  University,  for  a  corresponding 
specimen  where  the  whole  foot  was  preserved,  and  sent  on  to  me.  The 
case  was  that  of  an  aged  black  female,  and  the  nails  were  the  growth 
of  many  years,  their  length  being  very  nearly  equal  to  the  preceding ; 
they  had,  however,  kept  in  a  direction  forwards,  and  not  vertical  as  the 
preceding,  and  were,  therefore,  more  in  the  shape  of  plates.1 

In  cases  where  the  nail  has  been  lost  by  violence  or  disease,  the 
cutis  Tera  secretes  another ;  but  it  differs  from  the  first,  unless  the 
cutis  vera  has  been  restored  to  a  perfectly  healthy  action :  from  this 
cause,  we  see  in  individuals  thick  black  nails,  sometimes  cleft  longi- 
tudinally. 

The  nails  begin  to  appear  about  the  fifth  month  of  foetal  life,  and 
are  still  imperfect  at  birth.  When  analyzed,  they  seem  to  consist  in 
coagulated  albumen,  with  a  small  quantity  of  the  phosphate  of  lime. 


CHAPTER  IY. 
OF  THE  HAIRS. 

The  Hairs  (pili,  crines)  are  cylindrical  filaments,  which  are  found 
on  most  parts  of  the  skin,  excepting  the  palms  and  the  soles.  The 
finest  of  them  are  microscopical,  and  have  not  a  diameter  exceeding 
the  one-sixth  hundredth  of  an  inch. 

The  hairs  differ  much  in  their  size  and  appearance  in  the  several 
parts  of  the  body.  Those  on  the  head  (capilli,  csesaries)  grow  to  the 
greatest  length  of  any,  and  are  most  numerous  in  proportion  to  the 
space  they  occupy.  Those  which  surround  the  mouth,  and  are  on  the 
cheeks  (julus,  mystax,  barba),  exceed  the  others  in  size,  and  when 
allowed  to  grow,  are  next  in  length,  and  more  disposed  to  curl.  Those 
around  the  eyes  (cilia,  and  the  super-cilia)  are  not  disposed  to  exceed 
an  inch  in  length,  and  have  a  long  slender  spindle  shape.  Those  at 
the  orifices  of  the  nostrils  and  ears  are  of  the  same  habits  as  the  latter. 
Those  of  the  arm  pit  (glandebalse),  and  about  the  organs  of  generation 
(pubes),  are  limited  to  the  growth  of  a  few  inches. 

In  the  male  subject  there  are  hairs  of  considerable  length  on  the 
sternum,  and  about  the  nipples,  an  arrangement  which  seldom  occurs 

1  She  had  been  an  inmate  of  the  Almshouse  there,  and  died  in  the  latter  part  of 
1845. 


848  INTEGUMENTS. 

in  females.  In  most  individuals,  hairs  are  found  over  the  whole  re- 
maining surface  of  the  body ;  but  in  females,  and  in  many  males,  they 
are  too  fine  to  be  readily  visible.  In  some  subjects,  brought  into  our 
dissecting-rooms,  the  pilous  system  has  been  so  developed  as  to  form  a 
shaggy  coat  over  the  whole  body,  and  almost  to  conceal  the  skin. 

We  are  informed,  on  the  authority  of  Jameson's  Tour,  of  a  man,  at 
Ava,  covered  from  head  to  foot  with  hair.  That  on  the  face  and  ears 
is  shaggy,  and  about  eight  inches  long;  on  the  breast  and  shoulders  it 
is  from  four  to  five.  He  is  a  native  of  the  Shan  country,  and  married 
a  Burmese  woman,  by  whom  he  has  two  daughters :  the  youngest  is 
covered  with  hair  like  her  father,  but  the  eldest  resembles  her  mother.1 

In  the  female  the  hairs  of  the  head  are  more  abundant,  and  reach  a 
greater  length  than  they  do  in  the  male.  As  a  general  rule,  the  color 
of  the  hairs  corresponds  with  that  of  the  eyes  and  of  the  skin,  and  the 
darker  they  are,  the  coarser.  According  to  Withoff,  a  quarter  of  an 
inch  square  of  skin  has  upon  it  147  black  hairs,  while  the  same  extent 
has  162  hazel,  or  182  white  ones,  in  other  individuals. 

Each  hair  consists  in  a  bulb  and  in  a  stalk.  The  bulb  is  the  adherent 
extremity,  and  is  whiter,  softer,  and  generally  larger  than  any  other 
part ;  it  is  received  into  a  follicle,  compared  appropriately  by  Malpighi 
to  the  vase  containing  a  flower  or  plant,  and  which  is  deposited  most 
commonly  in  the  subcutaneous  cellular  substance,  but  sometimes  in  the 
skin  itself.  This  follicle  is  of  an  oblong  ovoidal  shape  ;  its  open  orifice 
is  continuous  with  the  surface  of  the  skin,  while  its  deep  end  is  closed, 
and  has  some  filaments  passing  from  it  to  the  adjacent  cellular  sub- 
stance. It  is  formed  of  two  membranes  ;  the  external  is  white,  strong, 
and  continuous  with  the  derm  or  cutis  vera ;  the  second,  being  within 
the  last,  is  more  soft,  delicate,  and  vascular,  and  seems  to  be  a  con- 
tinuation of  the  rete  mucosum,  and  of  the  cuticle,  if  we  are  to  consider, 
with  the  microscopists,  the  two  as  identical.  This  layer  comes  out  with 
the  bulb  of  the  hair,  on  extraction  of  the  latter.  From  the  bottom  of 
the  cavity  of  the  follicle,  a  small  conoidal  papilla  erects  itself  towards 
the  orifice.  In  the  human  subject  it  is  very  imperfectly  developed,  being 
scarcely  visible,  but  is  sufficiently  so  in  the  bristles  of  the  upper  lip  of 
the  larger  animals.  This  papilla  is  vascular,  and  from  the  dissections  of 
M.  Beclard,  on  the  human  subject,  and  of  M.  Rudolphi,  on  the  musta- 
chios  of  seals,  is  furnished  with  nerves.  The  mode  of  approach  of  its 
vessels  is  not  yet  settled.  M.  Gaultier  says  that  the  arteries  pass  from 
the  surface  of  the  skin  into  the  orifice  of  the  follicle,  and  then  descend, 
In  a  serpentine  manner,  between  its  two  membranes  to  the  bottom.3  M. 
Bdclard,  on  the  contrary,  considers  them  to  pass  through  the  bottom 
of  the  follicle.  Each  piliferous  follicle  is,  moreover,  furnished,  within 
its  orifice,  with  many  small  sebaceous  follicles  arranged  round  it. 

The  bulb  of  the  hair  has  in  it,  as  seen,  a  conoidal  cavity,  open  at 
its  base  and  receiving  the  conoidal  papilla  of  the  follicle.  The  hair 
receives  its  nourishment  from  the  papilla  by  a  successive  deposit  of 
nucleated  cells  just  like  a  nail.  The  hair  is  moreover  attached  to  the 
gkin  by  the  cuticle  ;  for  the  latter,  having  reached  the  orifice  of  the  fol- 

1  Littell's  Museum,  No.  69,  p.  412. 

2  J.  Cloquet,  Anat  de  1'Homme,  pi.  cxviii.  fig.  ii. 


THE  HAIR.  349 

Fig.  114.'         Fig.  11 5.2 


Fig.  114.  Pulp  of  a  Hair  injected,  after  Hunter.  See  Catalogue  of  the  Museum  of  the  College  of 
Surgeons,  Physiological  Series,  vol.  iii.— 1.  Cut  surface  of  hair.  2.  The  pulp  3.  Injected  vessel 
ramifying  in  it. 

Fig.  115.  Whisker  of  a  Walrus  in  its  follicle,  after  Hunter.  See  Catalogue  of  the  Museum  of  the 
College  of  Surgeons.— 1.  Cut  surface  of  lip.  2.  Cutis.  3.  External  sheath  of  the  follicle.  4.  Internal 
sheath  continuous  with  the  cuticle,  which,  both  in  the  drawing  and  in  the  preparations  which  Mr. 
Hunter  has  left,  is  seen  to  line  the  follicle  to  the  point  of  attachment  of  the  bulb  of  the  hair.  5.  Pulp 
of  matrix.  6.  Shaft  of  the  hair.  7.  Large  nerve  going  to  it. 

licle,  is  then  reflected  for  some  distance  along  the  hair:  this  increases 
the  strength  of  the  attachment  of  the  hair  to  the  skin. 

The  stalk  of  a  hair  has  generally  the  loose  extremity  smaller  than 
any  other  part,  and  frequently  split.  When  examined  with  a  micro- 
scope, the  stalk  appears  to  consist  of  two  substances,  one  within  the 
other.  The  exterior  is  a  diaphanous  sheath  almost  colorless,  and,  from 
having  the  properties  of  the  epidermis,  may  be  considered  a  continua- 
tion of  it.  The  microscope  shows  it  to  be  formed  on  its  outside  by 
minute  scales,  resembling,  but  much  smaller  than  those  of  the  epi- 
dermis, and  arranged  into  rows  like  the  shingles  upon  a  house,  the  free 
edges  of  which  are  sometimes  transverse,  and  sometimes  oblique  or 
spiral.  The  stalk  of  the  hair  is  generally  of  a  cylindrical  shape,  occa- 
sionally it  is  flattened,  but  sometimes  grooved  on  one  side,  so  that  a 
transverse  section  of  it  resembles  in  outline  a  kidney.  The  interior 
consists  of  long  filaments,  parallel  with  one  another,  and  occasionally 
forming  a  tube  in  the  centre  of  the  fasciculus.  These  filaments  some- 
times part  spontaneously  by  the  splitting  of  the  envelop,  and  this 
may  at  any  rate  be  accelerated  by  soaking  the  hair  in  dilute  acid  and 
crushing  it.  The  filaments  of  a  hair  are  translucent,  and  exhibit  lon- 
gitudinal dark  streaks  intermixed  with  them,  which  are  produced  by 
collections  of  pigment  or  elongated  cell-nuclei.  The  filaments  are  flat, 
broad  near  the  middle,  and  pointed  at  the  end.  They  measure  about 

1  From  Muller'a  Pbysiol.  by  Baly.  « Ibid. 


350  INTEGUMENTS. 

the  4 ^ffflth  of  an  inch,  according  to  Henle.  The  tube,  as  well  as  the 
interstices  between  the  filaments,  is  filled  with  a  fluid  called  the  mar- 
row of  the  hair,  which  is  defective  in  the  fine  hairs  over  the  body, 
and  does  not  always  exist  in  those  of  the  head.  This  substance  cor- 
responds with  one  of  the  layers  of  the  rete  mucosurn  of  the  skin,  and 
contains  the  coloring  matter.  The  marrow  or  medulla  appears  to  be 
formed  of  colorless  cells,  intermingled  with  the  pigment  cells.  The  pro- 
bability is  that  the  whole  hair  is  a  continuation  of  the  rete  mucosurn, 
and  of  the  epidermis:  whether  we  are  disposed  to  consider  these  layers 
as  distinct  or  identical.  The  canal  in  the  centre  of  the  hair  is  found  to 
be  remarkably  large  in  the  hog's  bristle  ;  it  is  also  well  seen  in  the 
supercilia :  the  follicle  and  bulb  are  best  studied  in  the  mustachios  of 
the  larger  animals.  According  to  Mr.  Heusinger,1  the  substance  of  the 
hair,  when  examined  with  a  microscope  of  strong  power,  exhibits  an 
areolar  appearance. 

Though  the  stalk  of  the  hair  is  destitute  of  blood-vessels  and  of 
nerves,  yet  it  is  probable,  from  the  sudden  changes  of  color  that  some- 
times occur  in  it  from  black  to  white,  owing  to  terror  and  grief,  that 
there  is  a  species  of  interstitial  circulation  going  on.  The  emaciated 
and  peculiar  appearance  which  sickness  gives  to  it  would  also  tend  to 
support  this  opinion.  Strictly  speaking,  the  hairs  are  devoid  of  sensi- 
bility, yet,  as  the  bulb  is  planted  over  a  sensitive  papilla,  they  commu- 
nicate certain  sensations  by  being  removed  or  touched.  Animals  apply 
their  mustachios  particularly  to  this  use,  in  groping  through  dark  places, 
or  when  they  are  deprived  of  sight.  The  hairs  are  eminently  hygro- 
scopic, moisture  lengthens,  and  dryness  shortens  them ;  this  property 
has  caused  them  to  be  applied  to  the  construction  of  hygrometers. 

In  certain  animals  the  hairs  are  erected  by  the  contraction  of  the 
subcutaneous  muscle.  The  movement  in  the  human  subject  correspond- 
ing with  that  is  the  effect  of  great  fright,  and  is  produced  by  the  con- 
traction of  the  occipito-frontalis  muscle. 

In  the  development  of  hair,  the  part  which  first  forms  is  the  follicle, 
the  young  hair  then  pierces  it  at  its  summit,  in  the  same  way  that  the 
tooth  pierces  its  capsule.  As  the  conical  papilla  or  matrix  at  the  bot- 
tom of  the  capsule  is  the  source  of  hair,  the  production  of  the  latter  is 
accomplished  by  a  blastema  being  secreted,  in  which  nucleated  cells  are 
developed.  The  cells  there  form  the  flattened  filaments  and  colored 
streaks  of  the  hair  stalk :  they  also  form  the  imbricated  scales  on  the 
surface  of  the  hair.  The  cuticular  layer  of  the  follicle  is  in  two  laminae, 
between  which  is  a  fine  transparent,  fenestrated  membrane,  discovered 
by  Henle.  The  death  of  the  capsule,  or  the  drying  up  of  its  fluids, 
occasions  the  fall  of  the  hair  and  prevents  its  regeneration.  In  old 
men  who  are  bald,  there  is  no  appearance  of  capsules;  while  in  persons 
from  whom  the  hair  has  fallen,  owing  to  sickness,  as  the  capsules  still 
remain,  they  soon  put  forth  another  crop  of  hair.  The  rudiments  of 
the  hair  are  seen  about  the  fourth  or  fifth  month  of  foetal  life.  The  first 
crop  (lanugo)  is  deciduous,  and  after  covering  the  body  of  the  foetus  like 
a  fine  down,  till  the  eighth  month  of  utero-gestation,  it  then  falls  off; 
sometimes,  however,  it  is  retained  either  in  whole  or  in  part  till  after  birth ; 

1  J.  Cloquet,  loc.  cit. 


THE  HAIR.  351 

this  is  particularly  the  case  in  regard  to  the  hair  of  the  head.  In  this 
deciduous  character  we  see  an  analogy  between  the  hair  and  the  teeth. 

When  the  hair  becomes  white  from  age,  the  conversion  of  color 
begins  at  the  loose  extremity,  another  proof  of  the  interstitial  circu- 
lation, or  change  of  particles  in  it.  The  same  fact  is  observable  in 
animals  who  change  color  only  for  the  winter.  But  the  restoration 
of  color  begins  at  the  root. 

It  is  probable,  in  those  cases  of  plica  polonica  attended  with  bleed- 
ing from  the  root  of  the  hair  when  it  is  cut,  that  the  vascular  papilla 
has  been  so  much  augmented  as  to  elevate  itself  above  the  level  of  the 
cuticle,  and  of  course  interferes  with  the  sweep  of  the  razor  employed 
in  shaving  the  head.  Ignorance  in  regard  to  the  organization  of  the 
hair,  and  a  slight  inclination  to  the  marvellous,  would  magnify  this  into 
every  hair,  in  such  a  disease,  being  a  sort  of  branch-pipe  from  the 
general  circulating  system,  and  therefore  bleeding  upon  being  wounded. 
Many  of  the  victims  to  this  disease,  accordingly,  prefer  the  loathsome 
matting  of  the  hair  with  which  it  is  accompanied  to  the  supposed  risk 
of  dying  by  hemorrhage. 


BOOK   III. 

MUSCLES. 


PART  I. 
MUSCLES  AND  TENDONS  IN  GENERAL. 


CHAPTER  I. 
HISTOLOGY  OF  THE  MUSCLES.1 

THE  Muscles  (musculi)  by  their  contraction  produce  the  various 
flexions  of  the  body,  and  are,  therefore,  the  organs  of  motion.  They 
may  be  known  by  their  redness,  softness,  irritability,  contractility,  and 
by  their  being  formed  of  long  parallel  fibres.  The  redness,  however, 
does  not  always  attend  them ;  as  this  color  is  very  faint  in  the  foetus, 
and  does  not  exist  at  all  in  animals  that  have  not  red  blood.  They 
form  a  very  considerable  share  of  the  whole  bulk  of  the  body. 

Though  the  most  perfect  organs  of  motion,  and  producing  it  more 
efficiently  and  rapidly  than  any  other  apparatus,  they  are  not  indis- 
pensable to  it ;  for  they  are  not  observable  in  animals  of  a  very  low 
grade,  which  apparently  consists  of  a  sort  of  cellular  or  mucous  sub- 
stance. In  the  next  grade  of  animals,  as  the  worms,  where  there  is  a 
deficiency  both  of  bony  and  of  cartilaginous  skeleton,  the  muscles  are 
perceptible,  and  produce  locomotion  by  their  attachment  to  the  skin  or 
integuments  ;  and,  finally,  in  animals  which  have  a  skeleton,  the  mus- 
cles are  almost  exclusively  attached  to  its  different  points,  and  by  alter- 
nately approximating  them,  effect  locomotion. 

The  muscles  of  the  human  body  are  referable  to  two  classes,  in 
consequence  of  their  position  and  functions,  though  they  present  a 
close  similitude  of  structure  everywhere.  The  most  numerous  class, 
as  well  as  that  in  which  they  are  of  the  greatest  magnitude,  are  the 
muscles  of  voluntary  motion,  or  of  Animal  life  :  they  are  placed  be- 

1  These  organs  were  very  imperfectly  known  to  the  ancients,  excepting  Galen,  and  had 
not  generally  received  names  till  the  time  of  Sylvius,  A.  D.  1587.  The  paramount  author- 
ity of  Albinus,  in  this  department  of  Anatomy,  in  his  work,  Historia  Musculorum  Hominis, 
Leyden,  1734,  has  induced  me  to  adopt  it  as  the  standard  of  correct  description  and  nomen- 
clature, with  but  few  exceptions. 

VOL.  i.— 23 


354  MUSCLES. 

tween  the  skeleton  and  the  integuments,  and  constitute  the  principal 
bulk  of  the  extremities,  and  also  afford  a  thick  fleshy  covering  to  the 
trunk.  The  second  class,  being  the  muscles  of  Organic  life,  is  con- 
tained within  the  large  cavities  of  the  skeleton,  and  forms  a  portion  of 
the  structure  of  the  circulatory,  of  the  digestive,  and  of  the  urinary 
organs.  This  set  produces  the  principal  internal  motions  of  the  ani- 
mal economy. 

Every  muscle  is  surrounded  by  an  envelope  of  fibro-cellular  sub- 
stance, called  its  sheath  (membrana  musculorum  communis)1  which 
at  different  points  of  the  body  exhibits  various  degrees  of  condensation. 
In  the  muscles  of  voluntary  motion  these  sheaths  are  formed  by  par- 
titions, going  from  the  aponeurotic  expansions  just  beneath  the  skin, 
to  the  periosteum,  and  are  the  prolongations  which  induced  Bichat  to 
consider  the  periosteum  as  the  centre  of  the  desmoid  system.  These 
sheaths  in  some  cases  preserve  to  a  considerable  extent  the  ligament- 
ous  appearance,  but  generally  cellular  substance  predominates  in  them. 
Upon  their  existence  is  founded  the  great  variety  of  views  and  de- 
scriptions which  the  later  anatomists  have  taken  of  the  fasciae  of  the 
human  body,  some  choosing  to  describe  them  in  one  way  and  some  in 
another.  The  sheaths  of  the  second  class  of  muscles  are  composed  of 
a  much  finer  and  looser  coat  of  cellular  substance  than  those  of  the 
first,  and  are  commonly  described  as  laminae  or  tunics,  to  the  organs  to 
which  they  respectively  belong.  In  every  case,  however,  from  the  in- 
ternal face  of  the  sheaths,  a  great  many  partitions  pass  off,  which  pene- 
trate the  body  or  thickness  of  the  muscle,  and  divide  and  subdivide  it 
into  fasciculi,  and  into  fibres,  even  to  their  most  minute  condition. 
These  partitions  become  thinner,  the  more  they  are  multiplied. 

Many  of  the  muscles  are  subdivided  by  fissures  into  several  large 
portions  called  Fasciculi,  or  Lacerti.  These  vary  very  much  in  size, 
and  in  their  distinctness  from  each  other.  Some  are  so  large  and  so 
widely  separated  as  to  appear  like  distinct  muscles;  such,  for  example, 

Fig.  116. 


A  few  Muscular  Fibres,  trinjr  part  of  n  small  Fasciculus,  highly  magnified,  showing  the  transverse 
Striae,     a.  End  view  of  b  6,  fibres,     c.  A  fibre  split  into  its  fibrillue. 

1   Haller,  Element.  Physiol.  torn.  i. 


HISTOLOGY  OF  THE  MUSCLES.  355 

are  the  biceps  of  the  arm  and  of  the  thigh,  the  deltoid,  the  columnce 
carncse  of  the  heart,  and  several  others.  But  the  greater  part  of  the 
fasciculi  are  strictly  parallel  with  each  other,  and  merely  separated 
by  a  thin  lamina  of  cellular  substance.  The  fasciculi  are  again  sub- 
divisible into  fibres,  which  from  their  smallness  are  scarcely  appre- 
ciable to  the  naked  eye,  and  they,  when  examined  with  powerful  micro- 
scopes, admit  of  farther  division  until  we  reach  the  primitive  filaments 
or  fibrillse.  On  this  account  some  anatomists  have  undertaken  to 
classify  the  fasciculi  under  the  terms  of  first,  second,  and  third  orders. 
The  filamentous  arrangement  of  muscles  is  rendered  still  more  distinct 
by  boiling  them,  or  by  immersing  them  in  alcohol. 

The  structure  of  the  muscular  fibre  has  been  studied  with  great  at- 
tention by  microscopical  observers.  From  such  observations,  it  ap- 
pears that  their  shape  is  prismatic,  pentagonal,  hexagonal,  sometimes 
rounded. 


SECT.  I. — MUSCLES  OF  ANIMAL  LIFE. 

The  present  state  of  the  minute  anatomy  of  the  muscles  of  animal 
life  points  out  the  following  conditions.  The  fibres  are  arranged  with 
great  regularity  and  in  parallel  lines,  so  far  as  individual  fasciculi  are 
concerned.  The  smallest  fibre  visible  to  the  naked  eye  is  by  the  mi- 
croscope ascertained  to  be  itself  a  fascis,  formed  of  ultimate  subordinate 
fibrillse  of  a  cylindrical  or  polygonal  shape,  and  closely  applied  to  each 
other.  In  order  to  see  these  ultimate  fibrillae,  which  admit  of  no  far- 
ther division,  the  best  way  is  to  take  the  smallest  distinct  fibre,  espe- 
cially of  a  fish,  and  pull  it  apart  in  its  length  ;  its  transverse  rupture 
will  then  show  by  the  microscope  a  finely  divided  filamentous  end, 
which  filaments,  from  the  incapability  of  a  farther  separation,  are  con- 
sidered as  being  the  ultimate  fibres.  This  fascis  of  ultimate  fibres  is 
held  together  by  a  sheath  of  its  own,  called  the  Myolemma,  or  Sarco- 
lemma,1  which  is  conceived  to  have  a  texture  different  from  common 
cellular  substance,  and  consists  of  a  transparent,'  very  delicate,  but 
strong  and  elastic  membrane,  which  insulates  the  fascis  from  every 


Fig.  117. 


Fragments  of  an  Elementary  Fibre  of  the  Skate,  held  together  by  the  untorn  but  twisted  sarcolemma. 

kind  of  contiguous  structure.     The  Sarcolemma  is  amorphous,  or  has 
no  formal  texture  generally,  but  in  the  case  of  very  large  fibres  it  has 

'  Todd  and  Bcfwman,  p.  155. 


356  MUSCLES. 

an  indistinct  evolution  of  filaments  which  are  interwoven.  The  sarco- 
lemma  of  a  muscular  fascis  is  occasionally  upon  the  rupture  of  the  lat- 
ter left  entire,  which  is  a  good  way  of  studying  it,  in  which  case  there 
is  some  resemblance  to  a  small  sword  broken  in  its  scabbard ;  another 
good  way  to  see  it  is  by  maceration,  which,  by  causing  the  muscular 
fascis  to  swell,  ruptures  the  sarcolemma  in  spots,  or  elevates  it  so  as  to 
resemble  hernia.  -  It  is  considered  to  have  nothing  to  do  with  either 
the  longitudinal  or  transverse  striae  of  muscles,  and  not  to  be  even 
perforated  by  the  nerves,  or  by  the  capillary  blood-vessels. 

A  question  still  unsettled,  is  whether  one  of  those  smallest  muscular 
fasces  is  solid,  or  has  a  hollow  in  the  midst  of  its  ultimate  fibres.  The 
fascis  of  the  human  muscle  is  from  about  the  two-hundredth  to  the  six- 
hundredth  part  of  an  inch  in  diameter.  According  to  Bowman,  the 
diameter  of  a  fibre  or  fascis  is  about  the  ^^th  of  an  inch,  being  rather 
more  in  the  male  and  less  in  the  female.  It  is  larger  in  reptiles  and 
in  fish  than  in  other  vertebrata ;  it  is  smallest  in  birds,  and  what  is 
remarkable,  it  observes  no  proportionate  size  to  the  species.  Thus  it 
is  larger  in  the  Chaffinch  than  in  the  Owl,  in  the  Cat  than  in  the 
Horse,  in  the  Frog  than  in  the  Boa,  and  in  insects  generally  larger 
than  in  mammalia.1 

The  primitive  or  ultimate  fibrillae  have  a  diameter,  according  to  Wag- 
ner, of  from  about  the  9,000th  to  the  11,000th  part  of  an  inch,  and 
are  said  by  him  to  be  of  nearly  the  same  -dimensions  in  all  vertebrate 
animals,  in  insects  and  in  cray-fish;  from  five  to  eight  hundred  of 
them  compose  a  fascis  of  muscle  as  surrounded  by  its  sarcolemma. 

The  striped  or  bead-like  muscular  fibre  is  found  in  all  muscles  sub- 
ject to  the  will,  and  also  in  the  pharynx,  oesophagus,  and  in  the  heart. 
In  the  ossophagus  it  is  blended  with  the  smooth  muscular  fibre,  or  that 
of  organic  life,  being  found  at  various  distances  down  this  tube  in  dif- 
ferent individuals,  in  some  of  whom  it  reaches  to  within  an  inch  of 
the  stomach. 

Such  being  the  present  state  of  microscopical  observation  on  the 
anatomy  of  the  muscles,  it  is  remarkable  how  closely  the  truth  was 
approximated  by  the  earlier  descriptions. 

Among  the  first  efforts  to  settle  this  point  are  those  of  Hook,  com- 
municated to  the  Royal  Society  of  London,  about  the  year  1678. 
Having  reduced  into  filaments  the  muscles  of  the  cray-fish,  he  ob- 
served that  they  resembled  strings  of  beads  or  chaplets,  and  did  not 
exceed  in  diameter  the  hundredth  part  of  a  hair.2  A  fasciculus  of 
them,  the  size  of  a  hair,  looked  like  a  necklace,  composed  of  several 
strings  of  pearls.  Leeuwenhoeck3  considered  the  muscles  to  consist  of 
prismatic  bundles  of  filaments,  these  bundles  being  separated  by-thin 
membranes,  and  called  by  him  secondary  fasciculi.  The  filaments 
themselves  formed  the  primary  fibre,  and  were  also  separated  by  very 
thin  membranes;  their  diameter  he  estimated  at  about  the  two  thou- 
sandth part  of  a  line.  These  he  called  striae  carnosae,  and  learned  that 
in  insects  they  made  inflections  during  the  repose  of  the  muscle,  and 
which  disappeared  when  it  was  in  an  active  state.  The  striae  carnosae 

1  Carpenter,  Prino.  of  Phys.  p.  291.        « 

2  About  the  six-hundredth  part  of  an  inch.  3  Opera,  t.  i.  ii.  iii. 


HISTOLOSY  OF  THE  MUSCLES. 


357 


had  to  him  the  appearance  of  being  composed  of  globules,  which  he 
had  some  difficulty  in  distinguishing  from  the  inflections  or  wrinkles. 
The  primary  fibre,  small  as  it  is,  he  thought,  consisted  of  a  great  num- 
ber of  still  more  delicate  fibres,  which  he  called  fibrae  intimae. 

Prochaska1  divides  also  the  muscles  into  three  orders  of  bundles  of 
fibres ;  the  first,  second  and  third,  which  are  respectively  kept  asunder 
from  their  fellows  by  sheaths  of  cellular  substance  penetrating  from 
the  general  sheath  of  the  muscle.  In  the  third  order,  or  that  of  the 
primitive  fasciculi,  the  fibres,  he  says,  are  flat,  of  a  thickness  somewhat 
unequal,  and  run  out  the  entire  length  of  the  muscle,  even  in  the  sar- 
torius.  These  fibres  are  composed  of  ultimate  filaments  of  a  prismatic 
shape,  and  whose  diameter  is  about  the  eighth  of  a  corpuscle  of  blood, 
which,  estimating  at  the  three-thousandth  part  of  an  inch,  his  measure- 
ment corresponds  with  that  of  the  striae  carnosas  of  Leeuwenhoeck.  He 
witnessed  also  the  undulations  of  the  fasciculi  and  of  the  fibres,  and 
attributed  it  to  the  pressure  of  filaments  of  cellular  substance,  of  ves- 
sels, and  of  nerves  which  traversed  their  surface. 

Fontana2  gave  especial  importance  to  the  transverse  striae,  which  had 
been  seen  by  others  upon  the  primitive  fasciculi,  by  considering  them 
to  be  the  points  of  junction  of  the  segments  of  the  primitive  fibres,  for 
the  latter,  he  said,  were  interrupted  at  equal  distances  by  lines  which 
looked  like  globules,  and  might  indeed  be  mistaken  for  wrinkles.  The 
latter  opinion  was  entertained  by  Treviranus  so  late  as  in  1816. 

The  transverse  stride  are  very  numerous  in  the  human  subject;  there 
are  from  six  to  fifteen  of  them  in  the  hundredth  of  an  inch;  their  dis- 
tance then  is  about  from  two  to  five  diameters  of  a  globule  of  blood, 
fixing  the  latter  at  the  -g^th  of  an  inch.  Bowman  puts  the  distance 
at  the  ^Vet;!!  of  an  inch. 

Fig.  118. 


Muscular  Fibrillse  of  the  Pig  magnified  720  diameters,  a.  An  apparently  single  fibril,  showing  the 
quadrangular  outline  of  the  component  particles,  their  dark  central  part  and  bright  margin,  and  their 
lines  of  junction,  crossing  the  light  intervals,  b.  A  longitudinal  segment  of  a  fibre  consisting  of  a 
number  of  fibrils  still  connected  together.  The  dark  cross  stripes  and  light  intervals  on  b  are  obviously 
occasioned  by  the  dark  specks  and  intervening  light  spaces  respectively  corresponding  in  the  different 
fibrils,  c.  Other  smaller  collections  of  fibrillae. 


De  came  musculari,  1778. 


*  Treatise  on  the  Poison  of  the  Viper,  t.  ii. 


358  MUSCLES. 

In  meat  which  is  prepared  for  the  table  by  roasting  or  boiling,  or  in 
a  muscle  which  is  contracted,  one  frequently  sees  the  fibres  undulated 
or  crooked.  By  Prochaska,  as  just  stated,  it  was  attributed  to  the 
bridling  of  the  fibre,  by  the  contraction  of  its  cellular  substance,  nerves, 
and  blood-vessels.  The  cause,  however,  is  not  well  ascertained ;  the 
condition  seems  to  be  one  of  the  peculiarities  of  muscular  fibre,  which 
it  manifests  when  in  a  state  of  contraction  only;  for  it  disappears  when- 
ever the  fibre  is  relaxed,  either  by  spontaneous  movement,  or  by  stretch- 
ing it  in  the  dead  body.  This  undulation  has  probably  contributed  to 
the  many  inexact  observations  on  the  structure  of  muscles.  Thus, 
Haller  thought  they  consisted  in  a  series  of  ovoid  vesicles,  which  length- 
ened in  a  state  of  relaxation,  and  became  more  globular  in  a  state  of 
contraction.  It  is  unnecessary  to  dwell  on  mere  errors  of  the  eyes 
or  of  the  imagination,  for  the  fact  seems  to  be  now  well  established, 
that,  though  the  muscular  fibre,  by  contracting,  loses  its  straight- 
ness  and  becomes  crooked,  yet  this  is  effected  without  change  in  the 
form  of  the  ultimate  globules  of  which  it  consists. 

Among  the  approved  accounts  of  the  ultimate  structure  of  muscular 
fibre,  are  those  of  Mr.  Bauer,  with  Sir  Everard  Home ;  and  of  MM. 
Prevost  and  Durnas.  These  gentlemen  concur  in  stating  that  the  re- 
sults have  been  uniform  in  all  animals,  to  which  their  observations  have 
been  extended.  That  the  muscular  fibre  is  a  series  of  globules,  resem- 
bling the  globules  of  the  blood  deprived  of  coloring  matter,  and  adher- 
ing in  a  line  to  each  other.  That  the  medium  of  adhesion  is  invisible 
from  its  transparency  and  want  of  color;  but  if  the  muscle  be  mace- 
rated in  water  frequently  changed,  that  this  medium,  from  its  greater 
solubility  and  more  ready  putrefaction,  may  be  removed  so  as  to  leave 
the  globules  detached  from  each  other,  and  still  resembling  the  glob- 
ules of  the  blood.  The  fact  of  the  globular  condition  of  the  muscular 
fibre,  as  stated,  was  pointed  out  by  Leeuwenhoeck  and  Hook;  it  is  also 
approved  by  the  testimony  of  M.  Milne  Edwards  and  M.  Dutrochet. 

The  opinions  of  the  still  more  recent  observers  are  but  slight  modifi- 
cations of  the  preceding,  and  it  is  perceived  that  the  basis  of  them 
was  evidently  laid  by  Leeuwenhoeck,  and  by  Hook.  Many  microsco- 
pical observers  have  entered,  since  1830,  the  lists  for  the  purpose  of 
elucidating  this  structure ;  an  attention  to  them  all  would  be  a  history 
of  opinions  incompatible  with  the  limits  of  a  class  book.1  Some  few 
may  be  quoted. 

Miiller,2  in  admitting  the  beaded  arrangement,  says,  however,  that 
it  is  incorrect  to  consider  it  as  the  result  of  a  mere  aggregation  of 
globules,  because  there  is  a  distinct  continuation  of  fibre  from  one  knot 
to  the  next.  Gerber3  admits  the  granular  appearance  of  the  primary 
fibres,  but  says,  that  it  seems  to  depend  on  very  short  sinuous  bendings. 

The  results  of  a  very  protracted  and  careful  investigation  of  the  mat- 
ter by  Dr.  Schwann,  are,  that  the  diameter  of  the  primitive  fasciculus 
varies  from  the  ^gth  to  4^th  of  an  English  line.  The  primitive  fibres 
of  a  rabbit,  which  he  asserts  to  be  the  most  suitable  animal  for  such  an 
inquiry,  he  says,  are  bead-like  filaments,  presenting  a  series  of  dark 

1  For  information  consult  Traite  d'Anatomie  Generate,  par  J.  Henle,p.  152,  Paris,  1843. 

2  Physiol.  p.  879.  3  Gen.  Anat.  p.  240,  text. 


HISTOLOGY  OF  THE  MUSCLES.  359 

points ;  these  points  being  in  the  bead-like  enlargements.  He  con- 
siders the  appearance  of  transverse  striae  to  be  produced  by  the  dark 
points  on  the  primitive  muscular  fibre.  These  points  are  at  uniform 
distances  from  one  another  in  the  same  primitive  fasciculus,  but  may 
be  very  different  in  other  and  even  contiguous  fasciculi.1 

This  bead-like  state  of  the  muscular  fibre  is  recognized  also  by 
Henle,2  who  lays  down  the  rule  that  all  muscles  attached  to  the  skele- 
ton have  this  varicose  condition. 

Notwithstanding  the  value  and  number  of  the  authorities  in  favor 
of  this  knotted  state  of  the  primitive  muscular  fibre  in  the  muscles,  at 
least  of  animal  life,  highly  reputable  testimony  is  opposed  to  it.  Va- 
lentin considers  that  the  primitive  fibres,  in  a  state  of  repose  and  of 
health,  are  straight  and  homogeneous,  but  become  varicose  while  in  a 
state  of  contraction.  He  says,  that  thin  alternate  elevations  and  de- 
pressions on  their  circumference  cause  a  bead-like  appearance,  either 
from  its  being  the  result  of  a  special  vaginiform  condition,  or  from  its 
being  merely  the  exterior  layer  of  the  primitive  filament.  The  central 
portion  of  the  latter,  he  concludes,  from  the  result  of  his  microscopic 
observations,  to  be  uniformly  cylindrical. 

Treviranus  considers  the  knotted  condition  of  the  muscular  fibres  to 
be  no  other  than  granules,  adhering  to  their  exterior  surface ;  such,  at 
least,  is  the  result  of  his  observations  upon  insects.  According  to  Fi- 
cinus,  the  fresh  muscular  fibre  is  straight,  and  it  is  upon  death  that  it 
is  resolved  into  a  chain  of  distinct  globules ;  the  latter,  indeed,  may  be 
simulated  by  the  simple  inflections  of  the  muscular  fibre. 

Krause,  after  holding  the  opinion  of  the  bead-like  state  of  the  mus- 
cular fibre,  has  more  lately3  retracted  the  idea  under  the  declaration 
that  this  irregularity  is  due  to  the  commencement  of  putrefaction,  and 
that  it  is  unusual  to  see  it  upon  fresh  fibres  at  the  beginning  of  a  dis- 
section. 

By  some  it  has  been  asserted  that  muscles  are  only  the  continuation 
of  blood-vessels.  To  this  it  is  replied,'1  that  though  insects  have  muscles, 
yet  they  have  not  blood-vessels,  so  that  the  former  cannot  be  a  continua- 
tion of  the  latter.  Moreover,  a  successful  injection,  though  it  may 
penetrate  very  finely  between  the  fibres,  so  as  to  cause  the  muscle  to 
swell  considerably,  yet  none  of  these  vessels  can  be  traced  into  the 
ultimate  fibre ;  the  blood-vessels  thereupon  do  not  penetrate  the  myo- 
lemma,  and  consequently  the  ultimate  muscular  fibre  is  free  from  blood- 
vessels, the  latter  being  only  contiguous  to  it.  The  vital  phenomena 
and  the  organization  of  muscular  fibre,  are  so  very  different  from  cellu- 
lar substance,  from  nerves,  and  from  vessels,  that  it  cannot  be  less  than 
a  distinct  structure. 

Notwithstanding  this  limitation,  which  is  put  upon  the  distribution  of 
the  blood-vessels,  every  muscle  is  abundantly  supplied  by  them.  The 
arteries  come  from  the  adjacent  large  trunks,  and  penetrate  at  different 
points  of  the  periphery  of  the  muscle.  They  first  of  all  pass  between 
the  larger  fasciculi  and  parallel  with  them  ;  they  then  divide  and  follow 
the  course  of  the  smaller  fasciculi ;  they  divide  and  subdivide  again 


J  Miiller,  Physiol.  p.  881.  2  Anat.  Gen.  p.  129,  t.  ii. 

3  Henle,  ut  supra,  p.  158,  vol.  ii.  «  Beclard,  Anat.  G£n. 


360  MUSCLES. 

after  the  same  rule,  till  they  become  mere  capillary  tube,s,  from  which 
the  nutritive  'matter  is  exhaled.  The  veins  accompany  the  arteries, 
and  receive  their  blood;  some  of  them  creep  along  the  surface  of  the 
muscle  without  having  corresponding  arteries.  Bichat  says  truly,  that 
they  are  injected  with  great  facility  from  their  trunks,  from  which  he 
supposes  that  their  valves  are  less  numerous  than  in  other  parts  of  the 
system. 

As  the  blood-vessels  do  not  penetrate  the  sarcolemma  or  proper 
sheath  of  a  fibre,  hence  the  nutritious  fluid  is  conveyed  by  imbibition 
to  its  final  place. 

The  color  of  the  muscular  fibre  seems  to  be,  in  a  measure,  independ- 
ent of  the  blood  which  circulates  in  it.  Some  animals  with  red  blood 

Fig.  119. 


Capillary  network  of  Muscle. 

have  white  "fibres,  as  frogs.  The  color  of  the  muscular  fibre  is  not 
materially  altered  in  animals  that  have  been  suffocated.  The  muscular 
fibres  of  the  intestines  and  of  the  bladder,  though  abounding  in  blood- 
vessels, are  whiter  than  the  muscles  of  voluntary  motion. 

Lymphatics  have  been  injected  in  the  intervals  between  contiguous 
muscles  and  between  their  fasciculi. 

The  Nerves  of  the  muscles  are  large  and  abundant,  as  the  nerves  of 
the  brain  and  spinal  marrow  are  chiefly  spent  upon  them.  They  are 
generally  proportioned  to  the  size  of  the  muscle  which  they  have  to 
supply,  but  there  is  some  variety  in  this  respect.  They  accompany  the 
arteries,  and  are  united  to  them  by  cellular  substance.  Their  ultimate 
terminations  are  traced  with  great  difficulty,  and  there  is  consequently 
an  uncertainty  on  this  subject.  Before  they  disappear,  they  become 
soft  by  divesting  themselves  of  their  cellular  envelop,  and  are  supposed 
to  bring  thus  their  medullary  tubules  in  immediate  contact  with  the 
muscular  fibre,  though  like  the  blood-vessels  they  do  not  penetrate  the 
sarcolemma  or  sheath  of  muscular  fibre.  The  recent  observations  of 
MM.  Prevost  and  Dumas  are  thought  to  throw  some  light  on  this 
matter,  and  have  been  received  with  a  very  respectful  attention.  They . 
say,  that  by  macerating  in  clean  water,  and  in  a  dark  place,  the  muscle 
of  a  bullock,  and  then  throwing  a  strong  concentrated  light  upon  it, 
the  distinction  of  color  between  the  nerves  and  the  muscular  fibres 
becomes  very  apparent.  With  the  aid  of  a  microscope  and  a  fine 
knife,  the  nervous  ramifications  may  be  then  traced.  The  trunk  of 
the  nerve  enters  the  muscle  parallel  with  its  fibres,  and  soon  begins  to 


HISTOLOGY  OP  THE  MUSCLES. 


361 


give  off,  at  right  angles,  lateral  filaments,  which  penetrate  between  the 
fasciculi  and  fibres  of  the  muscles,  and  may  be  followed  to  the  top  of 
the  undulations  formed  on  the  muscular  fibres.  These  lateral  filaments 
at  some  places  are  two  in  number,  which  pass  at  some  distance  from 
each  other,  but  parallel,  and  terminate  by  an  interchange  of  filaments  ; 
at  other  places  the  terminating  branches  are  spread  out  transversely 
to*  the  muscular  fibre,  and  end  by  forming  loops  with  themselves. 

Fig.  120. 


Loop-like  termination  of  the  Nerves  in  Voluntary  Muscle. 

According  to  this  view,  the  nervous  filaments,  strictly  speaking,  have 
no  termination,  but  run  again  into  the  source  from  which  they  are 
derived. 

The  chemical  analysis  of  muscles  shows  them  to  be  composed  of 
fibrin,  albumen,  gelatin,1  extractive  matter,  the  phosphate  of  soda, 
ammonia,  and  of  lime,  and  of  the  carbonate  of  lime.  The  extractive 
matter  of  the  muscle  may  be  removed  by  maceration,  in  clean  water 
often  changed.  If  it  be  allowed  to  remain  long,  it  assumes  certain 
appearances  in  its  putrefaction  peculiar  to  itself,  but  occasionally  it  is 
converted  into  a  substance  resembling  spermaceti.  When  a  muscle  is 
exposed  to  boiling  water,  the  albumen  is  raised  to  the  surface,  like 
foam  ;  the  gelatin  coagulates  when  the  muscle  is  cold,  and  the  fibrin 
appears  as  a  fibrous  grayish  substance,  insoluble  in  hot  water,  closely 
resembling  the  fibrin  of  the  blood,  and  evolving  large  quantities  of 
nitrogen  by  the  action  of  nitric  acid.  When  a  muscle  is  exposed  to 
the  fire  alone,  as  in  roasting,  the  albumen  is  hardened  ;  the  gelatin  is 
melted,  and  runs  off,  in  part,  with  the  juices  of  the  meat ;  the  extractive 

1  Whether  gelatin  is  to  be  considered  as  an  ingredient  of  pure  muscular  matter  appears 
to  be  now  doubted. 


362 


MUSCLES. 


matter  is  that  which  gives  a  dark  color  to  the  outside,  the  fibrin  is 
cooked  in  the  juices  of  the  meat,  and  is  then  rendered  very  tender. 
The  muscular  parts  of  animals  are  amongst  the  easiest  of  digestion. 

The  muscular  system  of  the  embryo  is  first  of  all  in  a  gelatinous 
state,  and  confounded  with  cellular  substance ;  but  at  two  months 
from  conception,  the  fibres  are  distinct,  and  at  four  they  begin  to  con- 
tract and  to  execute  different  motions. 

In  the  development  of  muscular  fibre,  it  is  ascertained  that  the 
Myolemma  is  first  formed,  and  that  by  a  file  of  cells  placed  end  to  end, 
which  are  converted  into  a  tube  by  the  removal  of  the  partitions  made 
by  the  ends  of  the  cells.  The  nuclei  of  the  cells  are  visible  for  some 
time  after  the  muscular  fibre  is  formed,  but  they  finally  become  indis- 
tinct as  the  fibre  obtains  the  matured  state,  and  can  only  tie  exhibited 
by  particular  management.  They  are  supposed  to  act  as  centres  of 
nutrition  and  reparation,  their  activity  being  proportioned  to  the 
activity  of  the  muscle  itself. 


m 


Development  of  Muscular  F ibre,  after  Schwann.  1,2,  3,  are  fibres  from  the  dorsal  muscles  of  a  festal 
pig,  3%  inches  long.  3  represents  the  fibre  (2)  after  the  action  of  acetic  acid.  4,  5,  6 are  fibres  from 
the  muscles  about  the  humerus  of  a  foetal  piu  five  inches  long.  5  shows  the  nuclei  attached  to  the 
wall  of  the  tube ;  in  4  and  6  is  also  seen  the  gradual  deposition  of  the  substance  from  which  the  fibrillae 
are  formed  on  the  inner  surface  of  the  tubular  fibre  (magnified  about  450  diameters). 

The  muscular  system  is  subject  to  varieties  of  conformation.  Robust, 
muscular  individuals  frequently  have  supernumerary  muscles  and  su- 
pernumerary heads  to  their  muscles,  particularly  in  the  extremities.  In 
monstrous  foetuses  it  sometimes  happens  that  the  muscular  system  is 
either  wholly  or  partially  supplanted  by  adipose  matter  and  by  infil- 
trated cellular  substance. 


SECT.  II. — THE  MUSCLES  OF  ORGANIC  LIFE. 

They  have  one  very  plain  distinction  from  those  of  Animal  Life ;  their 
fasciculi  have  frequent  anastomoses,  and  are  interlaced  in  a  retiform 
manner  one  with  another,  instead  of  continuing  distinct  and  in  parallel 
lines.  The  primitive  fibre  is,  according  to  Dr.  Schwann,  about  y^oijth 
of  an  English  line,  or  the  ysio  otn  °f  an  'luc^-  'm  diameter.  These  fibres 
are  also  destitute  of  the  transverse  striae,  so  remarkable  in  the  muscles 
of  animal  life.  They  are  almost  perfectly  smooth,  are  collected  into 
flattened  bands,  and  are  of  a  light  drab  color.  Here  and  there,  small 
inequalities  or  swellings  exist,  coming  from  elongated  corpuscles,  the 


MUSCULAR  MOTION.  363 

nuclei  of  their  formation  adhering  to  them.  The  fascis  formed  by  the 
bundle  of  primitive  fibres  measures,  in  its  transverse  diameter,  from 
the  oo'flyth  to  the  ^^^th  of  an  inch,1  and  is,  therefore,  about  the  size 
of  a  blood-corpuscle,  taking  the  latter  number  as  the  unit  of  measure- 
ment. Valentine  and  Todd  do  not  admit  the  interlacement  of  these 
fibres ;  the  latter  considers  the  appearance  as  the  result  of  the  elon- 
gated corpuscles  throwing  parts  of  the  fibre  out  of  focus,  and  thus  pro- 
ducing a  confused  reticulated  figure.  He  also  doubts  that  these  fibres 
are  invested  by  a  sarcolemma,  as  he  says  none  has  been  discovered  in 
an  unequivocal  manner. 

The  muscles  of  organic  life  are  soft,  transparent,  and,  for  the  most 
part,  deeply  seated.  The  boundaries  of  their  fibres  are  very  faint,  and 
though  cylindrical  of  themselves,  yet  their  fasciculi  are  flat  or  prismatic 
from  pressure.  The  fibres  are  seldom  in  lines  perfectly  straight,  but 
are  for  the  most  part  bent  in  a  serpentine  way,  or  even  crimped  like 
the  unravelled  yarn  of  a  stocking.  The  arrangement  of  the  fibres  has 
some  resemblance  to  a  fine  nervous  plexus,  and  within  their  meshes  are 
placed  mucous  glands  and  other  objects.  Where  the  muscular  matter 
is  abundant,  as  in  the  bladder  or  the  womb,  it  is  arranged  into  layers, 
the  constituent  filaments  and  fasciculi  of  which  cross  respectively  at 
acute  or  right  angles. 

The  muscles  of  organic  life  are  supplied  with  soft  grayish  nerves, 
mostly  of  the  motory  description,  and  also  with  blood-vessels.  Their 
primary  filaments  are  not  penetrated  by  either,  but  the  latter  are  re- 
ceived into  the  interstices  of  their  fasces  and  fasciculi. 

It  is  asserted  that  the  Trichina  Spiralis,  a  small  worm  not  unfre- 
quently  found  in  the  muscles  of  animal  life,  is  seldom  or  never  in  those 
of  organic  life,  so  that  a  definite  line  is  thus  established  between  con- 
tiguous parts,  as  the  inferior  constrictor  muscle  of  the  pharynx  and  the 
top  of  the  ffisophagus.2 


CHAPTER  II. 
ON  MUSCULAR  MOTION. 

THE  muscles,  after  death,  are  soft,  easy  to  tear,  and  have  but  little 
elasticity ;  it  is  only  during  life  that  they  manifest  such  extraordinary 
strength,  and  retain  their  powers  of  motion.  The  general  phenomena 
of  the  latter  have  been  happily  expressed  by  the  word  myotility,  sug- 
gested by  M.  Chaussier.  These  phenomena  are,  contraction,  elonga- 
tion, and,  according  to  Barthez,  a  power  of  remaining  motionless  or 
fixed. 

In  contracting,  the  muscle  shortens,  swells  and  becomes  hard ; 
presents  wrinkles  on  its  surface ;  and  its  fibres  are  sometimes  thrown 
into  a  state  of  oscillation  or  vibration,  from  their  alternate  relaxation 

1  Todd  and  Bowman. 

*  Carpenter's  Princ.  of  Physiol.  p.  299. 


364  MUSCLES. 

and  contraction.  It  is  owing  to  the  vibratory  motion  in  the  fibres  of 
a  muscle,  during  their  contraction,  that  a  rustling  is  heard  on  the  appli- 
cation of  the  stethoscope  to  them.  The  hollow,  distant  rumbling  when 
the  meatus  externus  is  closed  by  the  finger,  is  owing  to  the  same  vibra- 
tion in  the  muscles  of  the  finger  employed.  This  is  readily  proved  by 
the  following  experiment:  close  the  meatus  with  the  end  of  the  handle 
of  an  awl  or  a  fork,  pressed  against  it  by  the  finger,  and  it  will  be  found 
that  the  muscular  vibrations  are  continued  along  the  instrument :  plant, 
afterwards,  the  point  of  the  instrument  upon  a  soft,  inelastic  substance, 
so  as  to  make,  in  that  way,  the  closure  of  the  meatus,  and  the  rumbling 
will  instantly  cease.  The  roaring  noise  of  sea-shells  may  be  explained 
in  the  same  way.  The  color  remains  the  same,  which  proves  that  there 
is  not  an  appreciable  addition  to  the  quantity  of  the  circulating  fluids. 
The  rapidity  with  which  this  contraction  may  take  place  is  manifested 
in  speaking,  in  running,  and  in  playing  upon  a  stringed  instrument ; 
and  its  strength  by  the  immense  burdens  that  some  individuals  can 
raise  and  bear. 

The  capability  of  the  muscles  to  endure  continued  action  is  exhibited 
daily  along  the  wharves  of  Philadelphia,  through  the  following  state- 
ment from  an  experienced  merchant: — A  corn  carrier  between  the  ages 
of  eighteen  and  thirty,  can  convey  21,000  Ibs.  of  corn  up  a  height  of 
thirty-five  feet  in  a  day,  by  the  following  method.  He  carries  two 
btfshels  of  120  Ibs.  weight  up  stairs  and  returns  to  the  wharf  in  about 
three  minutes.  In  each  day  he  goes  up  stairs  175  times  and  descends 
as  often — mounting  in  each  instance  thirty-five  steps,  a^nd  elevating  350 
bushels  by  this  process.  In  addition  to  this  he  elevates  the  bag  to  his 
shoulder  and  again  discharges  his  load — which  he  usually  carries  at  a 
run,  and  traverses  some  sixty  feet  of  wharf  and  as  much  more  of  store 
room.  This  labor  is  done  barefooted,  and  continued  off  and  on,  for  a 
period  of  about  seven  years,  when  exposure  and  intemperate  habits 
generally  kill  him  and  his  gang. 

The  power  of  elongation  or  relaxation  seems  to  be  an  active  state  of 
the  muscle,  as  well  as  its  contraction.  This  power  of  relaxation  or  of 
elongation  is  much  inferior  to  that  of  contraction;  it  seems  to  be  only 
what  is  sufficient  to  restore  the  muscle  to  its  proper  length,  so  as  to  put 
it  in  a  condition  for  the  removal  of  its  contractions.  The  fixedness  of 
muscles,  which  are  contracted  spasmodically,  and  their  retaining  this 
position  even  after  death,  until  putrefaction  begins  to  assail  them,  shows 
that  the  power  of  elongation  does  not  depend  simply  upon  elasticity; 
for  the  latter  quality,  being  as  much  the  attribute  of  dead  as  of  living 
matter,  would  be  brought  into  play  on  death. 

The  fixation  of  muscles  is  not  a  distinct  power,  but  merely  a  qualifi- 
cation of  contraction,  by  which  the  latter  may  be  arrested  at  any  given 
point,  and  retained  there. 

As  every  muscle  augments  in  thickness  during  its  contraction,  it  has 
been  a  subject  of  inquiry  to  physiologists  whether  the  whole  mass  of 
muscle  was  increased  or  diminished  by  its  contraction.  Swammerdam, 
in  order  to  ascertain  it,  put  an  insulated  solid  muscle,  not  yet  dead,  into 
a  tube  filled  with  water;  by  irritating  the  muscle,  and  causing  it  to  con- 
tract, the  water  descended;  but  this  result  was  not  uniform.  When  an 
arm  is  plunged  into  a  tube  properly  formed  and  filled  with  water,  if  the 


MUSCULAR  MOTION.  365 

muscles  be  caused  to  contract,  the  fluid  descends ;  but  the  objection  to 
the  inference  from  this  experiment  is,  that  when  all  the  muscles  of  the 
arm  are  caused  to  contract  violently,  the  introduction  of  arterial  blood 
is  much  arrested,  if  not  fully  stopped;  and  the  venous  blood  is  at  the 
same  time  expelled:  so  that  the  change  in  the  size  of  the  member  may 
be  accounted  for  in  that  way.  The  experiments  of  Erman  on  eels, 
fully  immersed  in  a  fluid,  and  submitted  to  galvanic  influence,  are  said 
to  substantiate  the  theory  of  the  muscles  diminishing  in  bulk  by  con- 
tracting.1 

The  activity  of  a  muscle,  though  closely  depending  upon  the  afflux  of 
blood  to  it,  is  not  entirely  so;  for  it  is  ascertained  that  galvanism  will 
cause  the  muscles  of  frogs  to  contract,  when  the  circulation  is  arrested 
by  death,  or  when  the  blood  is  coagulated,  or  even  when  it  has  been 
drawn  off.2  This  phenomenon,  however,  can  only  last  a  comparatively 
short  time;  for  a  muscle  soon  dies,  and  runs  into  a  state  of  putrefaction, 
after  its  vascular  and  nervous  communications  have  been  cut  off.  Phy- 
siologists have  entertained  very  different  opinions  on  the  causes  of  the 
muscles  contracting,  or  on  muscular  irritability,  as  it  is  called.  Some 
have  supposed  it  to  be  an  attribute  of  the  muscle  itself;3  others,  that 
it  depended  on  the  blood-vessels,  which,  by  bringing  a  greater  afflux  of 
fluids  into  its  interior,  between  its  fasciculi  and  fibres,  obliged  the  latter 
two  to  take  a  more  flexuous  course ;  and  others,  on  the  nerves.4  Any 
decision  on  this  point  is  inconclusive,  because  it  is  well  known  that 
perfect  muscular  action  requires  a  healthy  state  of  the  muscle,  and  an 
uninterrupted  nervous  and  sanguineous  influence;  so  that  it  seems  to 
be  a  result  from  the  combination  of  three  systems,  more  than  an  attri- 
bute of  one  alone.5 

MM.  Dumas  and  Prevost  say,  that  in  consequence  of  the  final 
nervous  ramifications  crossing  the  muscular  fibres  at  right  angles  to 
them  and  parallel  with  one  another,  the  galvanic  current  which  passes 
through  these  ramifications  causes  the  latter  to  approach  each  other 
reciprocally ;  whereby  the  muscular  fibres  to  which  the  ramifications 
are  fixed,  are  thrown  into  wrinkles.  It  is  clear,  from  this  theory, 
that  the  muscular  fibres  themselves  are  destitute  of  the  power  of  con- 
traction, and  that  they  are  only  the  frame-work  upon  which  the  gal- 
vanic batteries  of  the  nervous  system  are  displayed. 

For  a  further  exposition  of  these  phenomena,  and  of  the  opinions 
on  muscular  contraction,  the  reader  may  consult  with  advantage  the 
improved  modern  treatises  on  Physiology.6 

There  are  no  muscles  which  have  not  the  power  of  contracting  some 
time  after  apparent  death,  and  this  phenomenon  frequently  continues 
for  an  hour;7  it  is  uncommon  for  it  to  cease  with  the  apparent  ex- 
tinction of  life.  This  irritability  is  of  different  durations  in  the  differ- 

1  Beelard,  loc.  cit. 

*  Proclmslca  de  Carne  Muscular!,  Vienna.  1778. 
3  Haller,  Physiol. 

*  Le<rallois  sur  le  principe  de  la  vie. 

6  Meckel,  Anat.  Gen.;  from  Barzellotti,  Esame  di  alcuni  moderne  teoria  interne  alia  causa 
prossima  della  contrazione  moscolare,  1796. 

6  See  Miiller,  Dunglison,  Carpenter,  Todd  and   Bowman;   also  Gerber's  Gen.  Anatomy. 

'  The  visitations  of  Cholera  Asiatica  in  Europe  and  in  this  country  gave  to  many  person* 
an  opportunity  of  examining  this  singular  fact. 


366  MUSCLES. 

ent  muscles ;  it  is  first  lost  in  the  left  ventricle  of  the  heart ;  then  in 
the  large  intestines ;  afterwards  in  the  small,  and  in  the  stomach ; 
then  in  the  bladder,  then  in  the  right  ventricle,  the  iris,  and  in  the 
voluntary  muscles ;  of  which  those  of  the  trunk  die  first,  those  of  the 
inferior  extremities  next,  and  those  of  the  superior  last.  The  last  act 
of  life  is  in  the  auricles,  of  which  the  right  pulsates  longest.  Differ- 
ent circumstances  may  produce  some  variety  of  this  progress  in  the 
loss  of  muscular  irritability,  but  it  will  be  found  generally  correct.1 
The  experiments  of  Himly2  demonstrate,  that  laurel  water,  or  that  of 
bitter  almonds,  applied  to  the  stomach  or  brain,  renders  the  heart  in- 
sensible to  the  strongest  stimulants,  while  the  muscles  of  volition  con- 
tinue to  move  for  some  hours  afterwards.  The  duration  of  irritability 
is,  however,  much  varied,  according  to  the  nature  of  the  death,  and 
the  state  of  health  preceding.  Nysten  asserts,  that  he  has  seen  the 
right  auricle  of  a  robust  man  pulsate  nine  hours  after  death.  In 
death  from  chronic  diseases,  with  much  emaciation,  the  heart  ceases 
to  beat  shortly  after  intellectual  phenomena  cease.  In  death  from 
electricity ;  from  a  blow  upon  the  stomach  ;  from  the  inhalation  of 
carburetted  hydrogen  gas,  and  some  other  poisonous  ones,  muscular 
contraction  also  ceases  universally  in  a  few  moments,  and  cannot  be 
excited  by  any  artificial  means. 

The  irritability  of  the  muscles  is  so  modified  that  certain  stimulants 
are  peculiarly  appropriate  to  one  and  not  to  another.  For  example, 
light  is  the  specific  stimulant  to  the  iris  ;  a  mechanical  application  to  it, 
as  in  making  an  artificial  pupil,  is  borne  frequently  without  its  con- 
tracting. The  heart  is  very  sensible  to  mechanical  stimulants,  and 
additionally  so  when  they  are  applied  to  its  internal  surface. 

Some  of  the  muscles  are  regularly  under  the  influence  of  the  will, 
others  not  at  all  so,  which  has  given  rise  to  their  division  into  the 
voluntary  and  involuntary.  These  states,  though  kept  perfectly  dis- 
tinct from  each  other  in  health,  are  sometimes  blended  in  disease,  the 
voluntary  muscles  becoming  involuntary  in  their  actions,  and  the  in- 
voluntary voluntary ;  which,  however,  is  much  more  uncommon  than 
the  other. 

The  voluntary  muscles  being  generally  such  as  serve  for  locomotion 
and  speech,  receive  their  nerves  directly  from  the  spinal  marrow.  The 
involuntary  muscles  are  such  as  are  concerned  in  the  functions  of 
digestion,  respiration,  and  circulation,  and  which,  in  order  to  continue 
the  life  of  the  animal,  must  never  cease  their  actions  for  any  long  in- 
terval. It  is  worthy  of  remark,  that  apoplexy  and  other  cerebral 
affections  paralyze,  most  commonly,  the  voluntary  muscles  alone, 
while  the  others  retain  their  usual  state  and  sensibilities. 

When  irritability  is  entirely  gone  from  a  muscle,  and  it  is  actually 
dead,  the  whole  muscular  system  becomes  stiff,  beginning  with  the 
trunk,  then  the  inferior,  and,  lastly,  the  superior  extremities.  This 
stiffness  seems  to  be  independent  of  the  nervous  system,  as  the  de- 
struction of  the  spinal  marrow,  the  cutting  of  nerves,  and  herniplegia 
do  not  arrest  it.  It  is  thought,  by  M.  Be'clard,  to  be  analogous  to  the 

1  Meckel,  Anat.  Gen. 

2  Comnientatio  cle  Morte,  Goettingne,  1704. 


VOLUNTARY  MUSCLES.  367 

contraction  of  the  fibrin  of  the  blood ;  and,  like  the  latter,  does  not 
cease  till  putrefaction  begins.  The  degree,  as  well  as  the  time,  of  its 
access  is  variable  under  different  circumstances.  In  very  aged  persons; 
in  such  as  have  died  from  protracted  disease  attended  with  great  ema- 
ciation ;  in  scorbutic  and  gangrenous  diseases,  the  stiffness  comes  on 
quickly,  is  very  slight,  and  disappears  in  a  couple  of  hours.  But  in 
muscular  subjects  who  have  died  from  sudden  violence  or  from  acute 
diseases,  the  stiffness  is  sometimes  postponed  for  twelve  hours  or  more, 
and  may  continue,  in  the  winter,  from  three  or  four  days  to  a  week, 
or  even  longer,  depending  upon  the  access  of  putrefaction. 

The  sensibility  of  the  muscles  is  moderate.  When  they  have  been 
much  exercised,  they  only  give  out  the  sensation  of  fatigue.  In  am- 
putations, the  pain  of  cutting  through  them  is  not  equal  to  that  of  the 
skin.  In  inflammations  they,  as  most  other  parts,  have  their  sensi- 
bility exalted  to  an  exquisite  degree. 


CHAPTER  III. 

OF  THE  MECHANICAL  SHAPE  AND  ARRANGEMENT  OF  THE 
VOLUNTARY  MUSCLES. 

EVERY  muscle  consists  in  a  belly  and  in  two  extremities,  of  which 
the  one  that  is  the  fixed  point  is  the  head  or  origin,  and  the  other  is 
the  tail  or  insertion.  The  belly  or  body  is  the  fleshy  part;  the  extremi- 
ties are  generally  tendinous,  either  completely  or  partially. 

Some  of  the  muscles  arise  by  a  single  head,  and  are  inserted  into 
one  point.  Some  few  arise  by  a  plurality  of  heads,  but  have  a 
single  insertion,  as  the  biceps  flexor  of  the  arm,  and  of  the  thigh  ; 
others,  again,  have  a  single  head,  but  a  plural  insertion,  as  the  flexors 
of  the  fingers  and  of  the  toes ;  others,  again,  have  multiplicate  heads 
and  multiplicate  insertions,  as  the  muscles  of  the  back. 

The  most  simple  muscles  are  such  as  have  their  fibres  running  in  the 
direction  of  the  length  of  the  muscle,  of  which  there  are  many  ex- 
amples, as  the  sartorius,  the  biceps  flexor  cubiti,  the  semi-tendiuosus, 
and  others.  Others,  again,  have  their  fibres  running  obliquely  from  a 
tendon  or  a  bony  origin  on  one  side  of  the  muscle,  to  a  tendon  on  the 
other,  as  the  semi-membranosus,  the  peronei,  &c. ;  these  are  called 
musculi  semi-pennati.  Others  have  a  long  tendon  in  the  centre,  to 
which  the  fibres  converge  obliquely,  forming  an  angle  with  each  other; 
they  are  the  penniform  (musculi  pennati).  Others,  again,  are  formed 
of  a  congeries  of  small  muscles,  the  fibres  of  which  run  in  different 
directions,  and  are  intermixed  with  tendinous  matter,  as  the  deltoid  and 
subscapular.  As  the  strength  of  a  muscle  depends  upon  the  number  of 
its  fibres,  those  whose  fibres  go  obliquely  are  stronger  than  if  their 
fibres  had  run  longitudinally. 


368  MUSCLES. 


CHAPTER  IV. 
OF  THE  TENDONS  (TENDINES). 

THE  tendinous  extremities  of  muscles  present  themselves  under  two 
general  shapes :  one  is  funicular,  or  like  cords,  varying  in  shape  from 
cylindrical  to  paraboloid ;  the  other  membranous,  and  resembling  an 
aponeurosis.  They  both  adhere  with  great  tenacity  to  the  muscular 
fibres,  so  as  to  have  induced,  erroneously,  the  opinion  of  absolute  con- 
tinuity ;  but  maceration  and  boiling  will  separate  them,  and  the  course 
of  the  fibres  is  different  even  to  the  naked  eye ;  besides  the  very 
obvious  difference  in  color,  in  consistence,  and  in  vital  properties. 

From  the  observations  of  Dr.  Leidy,  it  appears  that  the  muscular 
fibres  end  in  a  rounded  manner.  The  filaments  of  areolar  tissue  which 
make  the  sheaths  of  muscular  fasciculi  generally  pass  in  a  diagonally 
crossing  manner,  around  the  fasciculi.  Sometimes  they  penetrate  be- 
tween the  fibres  and  intermingle  there  with  some  fine  filaments  of  elastic 
tissue.  At  the  extremities  of  the  muscular  fasciculi,  the  filaments  of 
areolar  tissue  straighten,  and  by  combining  with  the  fibrous  filaments 
found  there,  form  the  tendinous  connection  of  muscle.1  By  this  diagonal 
direction  of  the  investing  filaments,  extensibility  is  preserved  where 
wanted,  and  stability  is  secured  by  the  straight  line  at  the  end  of  the 
muscle  where  it  joins  the  tendon. 

The  tendons  are  surrounded  by  a  loose  cellular  membrane  or  capsule, 
which  permits  them  to  glide  freely  upon  each  other :  in  some  places 
this  membrane  is  wanting,  and  is  supplied  by  a  synovial  membrane 
answering  the  same  purposes. 

The  tendons  are  readily  recognized  by  their  white  and  shining  ap- 
pearance ;  they  have  no,  elasticity  or  power  of  elongation  and  con- 
traction, and,  therefore,  like  most  ligamentous  matter,  they  are  lace- 
rated sooner  than  they  can  be  stretched.  They  are  composed  of 
desmoid  tissue,  the  fibres  of  which  are  united  by  a  compact  cellular 
substance  in  small  quantities.  The  fibres  are  longitudinal,  and  may 
be  readily  separated  either  by  maceration  or  by  a  slight  boiling.  When 
a  round  tendon  is  prepared  in  this  way,  it  is  easy  to  flatten  it  out  into 
an  aponeurotic  membrane :  the  fibres  are  then  made  very  distinct,  and 
seem  to  adhere  to  each  other  by  lateral  fibrillge.  In  ordinary  health  no 
red  blood  penetrates  into  the  tendons,  but  if  they  become  inflamed,  as 
their  capillaries  then  enlarge,  they  admit  the  red  globules.  A  minute 
injection  well  managed  will  also  penetrate  between  their  fasciculi,  and 
show  itself  in  oblohg  meshes  whose  connections  cross  the  fasciculi ;  as 
the  capillaries,  however,  have  a  size  superior  to  that  of  the  ultimate 
fibrillas  of  tendon,  the  latter  are  not  penetrated  by  them,  but  get  their 
nourishment  by  imbibition.  Their  sensibility,  from  being  entirely  or- 

1  Quain&  Sharpey,  vol.  i.  p.  319. 


THE  TENDONS.  369 

ganic,  or  what  is  only  sufficient  for  the  internal  actions  of  the  organ, 
is  so  much  augmented  in  inflammation  as  to  be  very  manifest.1  No 
nerves  have  been  satisfactorily  traced  into  them  in  the  human  subject, 
though  Pappenheim  declares  his  success  in  this  matter  in  the  lower 
orders  of  animals.2  The  tendons  have  the  character,  at  large,  of  the 
desmoid  tissue,  but  are  more  gelatinous,  or  completely  soluble  in  boiling 
water,  than  the  ligaments.  They  have  a  great  affinity  for  the  phos- 
phate of  lime,  and,  hence,  we  frequently  find  them  hardened  and 
having  small  pieces  of  bone  in  them,  where  they  run  over  bony 
trochlese. 

1  A  knowledge  of  the  disposition  in  tendons  to  augment  their  powers  of  circulation  on 
being  inflamed,  together  with  the  late  Dr.  Physick's  great  success  in  the  treatment  of  false 
joints  by  a  seton  passed  through  the  cavity  of  the  fracture,  induced  me  in  a  tour  of  service 
at  the  Philadelphia  Hospital  to  try  the  effect  of  a  similar  plan  upon  a  ruptured  tendo-Achillis; 
which,  from  the  long  period  since  the  accident  had.  happened,  did  not  promise  a  cure  on  the 
ordinary  methods  of  treatment.     A  seton  of  silk  riband  was  accordingly  introduced,  and  kept 
in  its  place  for  six  weeks  and  a-half.     It  produced  considerable  pain,  tumefaction,  and  in- 
flammation, but  was  followed  by  a  perfect  reunion  of  the  ruptured  ends  of  the  tendon. — 
See  Chapman's  Med.  and  Phys.  Journal,  for  July,  1826.     For  a  highly  interesting  series  of 
experiments  on  animals,  undertaken  at  my  suggestion,  to  illustrate  the  same  thing,  see  An 
Essay  for  the  degree  of  Doctor  of  Medicine,  by  R.  L.  Fearn,  Id.  April  9,  1827. 

2  Muller,  Archives,  1843. 


VOL.  I.— 24 


BOOK  III. 


PART   II. 
SPECIAL  ANATOMY  OF  MUSCLES.1 


CHAPTER  I. 
MUSCLES  OF  THE  HEAD  AND  NECK. 

SECT.  I. — MUSCLES  OF  THE  FACE. 

Occipito-Frontalis. 

THE  occipito-frontalis,  a  single  muscle,  consists  of  two  symmetrical 
parts,  coming  from  the  back  of  the  head,  and  inserted  into  the  front  of 
it.  It  is  superficial,  being  placed  immediately  below  the  skin  of  the 
scalp,  and  has  four  bellies  of  muscular  fibres,  two  behind  and  two  be- 
fore, connected  by  a  thin  tendon  (galea  aponewrotica],  which  covers  all 
the  top  of  the  head.  The  tendon  adheres  by  a  short  cellular  tissue, 
having  no  adeps,  to  the  pericranium  below.  It  is  attached  to  the  com- 
mon integuments  above,  by  an  adhesion  made  by  strong  fine  filaments 
of  fibrous  matter,  passing  in  a  line,  more  or  less  vertical,  from  the 
under  surface  of  the  skin  to  the  outer  surface  of  the  tendon.  The 
common  integuments  on  the  hairy  scalp  are  formed  by  skin  and  by  a 
closely  adhering,  and,  indeed,  almost  inseparable  layer  of  granulated 
adeps,  intermixed  with  the  capsules  of  the  hairs,  and  the  fibrous  fila- 

1  I  may  here  mention,  once  for  all,  in  regard  to  the  muscular  system,  that  though  the  very 
rigid  mode  of  description  adopted  by  anatomists  may  lead  the  inexperienced  student  to  infer 
that  there  are  no  departures  from  a  common  standard,  and  that  one  invariable  type  for  the 
muscles  prevails  in  all  human  beings,  yet  there  will  be  found  upon  actual  dissection  occa- 
sional disagreements  with  the  best  established  descriptions,  and  which  it  is  of  some  use  to 
know.  Some  of  these  departures  are  common  enough,  others  very  rare ;  and  they  consist 
either  in  a  deficiency  or  a  redundancy  of  muscles.  Wishing  not  to  give  false  ideas  of  their 
importance  and  frequency,  and,  indeed,  fearful  of  doing  so,  they  are  purposely  introduced 
subordinately  in  notes:  many  of  them  have  been  observed  by  rne  personally,  others  are  re- 
corded in  different  medical  writings,  and  for  the  remainder  I  am  indebted  to  the  learned 
treatises  on  anatomy  of  T.  Soemmering  and  J.  F.  Meckei. 

No  part  of  the  muscular  system  varies  more  in  different  subjects  than  the  muscles  of  the 
back ;  but,  as  it  would  be  useless  to  enter  fully  on  such  trivial  details,  they  have  been  passed 
by,  except  in  a  few  instances. 


MUSCLES  OF  THE  FACE. 


371 


merits  alluded  to.  The  thickness  of  the  integuments  thus  situated  is 
frequently  three  lines. 

This  muscle  arises  from  the  superior  semicircular  ridges  of  the  os 
occipitis  by  tendinous  and  fleshy  fibres,  which  form  two  distinct  bellies 
(musculus  occipitalis}  about  an  inch  and  a-half  long,  one  on  each  side 
of  the  bone.  Its  tendon,  when  carefully  traced,  will  be  found  termi- 
nating a  little  in  front  of  the  coronal  suture,  in  the  two  anterior  fleshy 
bellies  (musculus  frontalis)  which  cover  the  whole  front  part  of  the  os 
frontis.  The  internal  edges  of  these  latter  are  in  conjunction  below. 

It  is  inserted,  on  each  side,  fleshy,  into  the  superior  margin  of  the 
orbicularis  oculi  and  of  the  corrugator  supercilii ;  and,  by  its  nasal  slip, 
into  the  internal  angular  process  of  the  os  frontis,  and  into  the  root  of 
the  os  nasi. 

It  pulls  the  skin  of  the  head  backwards  and  forwards,  and  throws 
that  of  the  forehead  into  horizontal  wrinkles.  It  also  elevates  the 
supercilia.1 

Fig.  122. 


A  front  view  of  the  superficial  layer  of  Muscles  on  the  Face  and  Neck.  1,  1.  Anterior  bellies  of  the 
occipito-frontalis.  2.  Orbicularis  or  sphincter  palpebrannn.  3.  Nasal  slip  of  occipito-frontalis.  4. 
Anterior  auriculae.  5.  Compressor  naris.  6.  Levator  labii  superiorisalaeque  nasi.  7.  Leyator  anguli 
oris.  8.  Zygomaticus  minor.  9.  Zygomaticus  major.  10.  Masseter.  11.  Depressor  labii  superioris 
alaequenasi.  12.  Buccinator.  13.  Orbicularis  oris.  14.  The  denuded  surface  of  the  inferior  maxil- 
lary bone.  15.  Depressor  anguli  oris.  16.  Depressor  labii  inferioris.  17.  The  portion  of  the  platysma- 
myoides  that  passes  on  to  the  mouth.  18.  Sterno-hyoideus.  19.  Platysma-myoides.  It  is  wanting 
on  the  other  side  of  the  figure.  20.  Superior  belly  of  the  omo-hyoidcus  near  its  insertion.  21 .  Sterno- 
cleido-mastoideus.  22.  Scalenus  medius.  23.  Inferior  belly  of  01 
trapezius. 


omo-hyoid.    21.  Cervical  edge  of  the 


Compressor  Naris. 

The  compressor  naris  arises  by  a  pointed  beginning  from  the  root  of 
the  ala  nasi,  and  spreads  like  a  fan  over  the  lateral  parts  of  the  nose 


Varieties.     Its  fleshy  portion  is  said  to  have  covered,  in  some  instances,  the  whole  skull- 


cap. 


372  MUSCLES. 

just  above  the  ala ;  it  is  inserted  into  its  fellow  of  the  opposite  side 
along  the  cartilaginous  dorsum  of  the  nose,  and  into  the  lower  part  of 
the  os  nasi,  being  there  connected  with  the  nasal  slip  of  the  occipito- 
frontalis. 

This  muscle  consists  of  thin  and  pale  fibres  placed  immediately  under 
the  skin.  If  it  act  from  both  extremities,  by  its  curved  fibres  being 
made  straight,  it  will  compress  the  nostril ;  but  if  it  act  from  its  dorsal 
margin,  assisted  by  the  nasal  slip  of  the  occipito-frontalis,  it  will  dilate 
the  ala  nasi,  and  has,  therefore,  been  called  Dilatans  Nasi,  by  Columbus. 

The  Dilatans  nasi  posterior  of  Theile  is  a  thin  small  plane  of  muscle 
arising  from  the  upper  lateral  margin  of  the  anterior  bony  naris,  and 
the  contiguous  cartilage  of  the  nose,  and  is  inserted  into  the  ala  nasi. 
It  draws  the  posterior  half  of  the  ala  nasi  backwards  and  dilates  the 
nasal  opening. 

Professor  Theile  informs  usxthat  a  microscope  is  required  to  detect  its 
nature.  With  such  qualifications,  its  addition  to  the  anatomical  descrip- 
tion of  the  face  is  at  least  of  equivocal  utility. 

Orbicularis,  or  Sphincter  Palpebrarum. 

The  orbicularis  oculi  or  palpebrarum  is  a  broad  circular  muscle,  lying 
immediately  under  the  skin  of  the  eyelids,  and  over  the  tarsi  cartilages. 
It  is  much  connected  with  essential  points  in  the  anatomy  of  the  eyelid. 

Its  diameter  exceeds  that  of  the  orbit  by  from  four  to  eight  lines  all 
around.  The  fixed  point  of  this  muscle  is  principally  the  ligamentum 
palpebrale  internum  and  the  internal  canthus  of  the  orbit ;  for,  in  the 
greater  part  of  its  extent,  besides,  it  is  only  loosely  attached  to  the 
parts  below. 

The  orbicularis  arises  along  the  whole  superior  margin  of  the  inter- 
nal palpebral  ligament.  It  also  arises,  by  short  tendinous  fibres,  from 
the  upper  end  of  the  nasal  process  of  the  os  maxillare  superius,  from  the 
internal  angular  process  of  the  os  frontis,  and  from  the  contiguous  part 
of  the  os  unguis. 

The  fibres  from  this  origin  compose  the  lamina  of  the  upper  eyelid. 
They  may  be  traced,  thence,  around  to  the  lower  eyelid,  and  are  found 
again  terminating  at  the  internal  canthus  of  the  orbit,  where  they  are 
fixed  into  the  anterior  margin  of  the  orbitar  process  of  the  upper  max- 
illary bone,  into  the  lachrymal  crista  of  its  nasal  process,  and  into 
the  inferior  margin  of  the  internal  palpebral  ligament  from  which  it 
arose. 

The  temporal  portion  of  this  muscle  is  attached  to  the  temporal  fascia, 
so  as  to  prevent  it  from  being  much  displaced.  It  is,  therefore,  obvious 
that  the  effect  of  the  contraction  of  the  upper  and  of  the  lower  half  of 
the  muscle  will  be  to  bring  the  eyelids  together.  The  fulcrum  of  motion 
is  the  internal  or  nasal  side,  as  manifested  by  the  radiated  wrinkling 
of  the  skin  at  that  point. 

The  interior  portion  of  this  muscle,  which  is  laid  upon  the  tarsi  car- 
tilages, is  very  thin  and  is  called  Ciliaris  by  Albinus :  this  distinction, 
which  is  too  arbitrary,  is  now  much  disused. 


MUSCLES  OF  THE  FACE.  373 

Tlie  Corrugator  Supercilii. 

This  muscle  is  placed  beneath  the  upper  margin  of  the  orbicularis, 
at  its  internal  extremity ;  by  which,  and  by  the  adjacent  portion  of 
the  occipito-frontalis,  it  is  concealed. 

It  arises  from  the  internal  angular  process  of  the  os  frontis,  and 
going  outwards  and  a  little  upwards,  its  fibres  are  lost  in  the  inferior 
margin  of  the  occipito-frontalis  and  in  the  superior  of  the  orbicularis. 

It  draws  the  eyebrow  and  the  skin  of  the  forehead  into  vertical 
wrinkles,  and  also  draws  them  over  the  eye  so  as  to  overshadow  it. 

The  Levator  Labii  Superior  is  et  Alss  Nasi 

Is  fixed  just  at  the  side  of  the  nose.  It  arises  by  a  pointed  produc- 
tion from  the  nasal  process  of  the  superior  maxillary  bone  at  the 
internal  canthus  of  the  eye,  and  by  a  broad  origin  from  the  anterior 
margin  of  the  orbitar  process  of  the  same  bone.  Passing  downwards, 
it  is  inserted  into  the  side  of  the  ala  nasi,  and  into  the  upper  lip,  being 
narrower  below  than  above.  The  part  of  this  muscle  which  comes 
from  the  orbitar  process  is  so  distinct,  that  Albinus  and  the  continental 
anatomists  of  Europe,  give  it  the  exclusive  name  of  Levator  Labii 
Superioris. 

It  draws  the  upper  lip  and  the  ala  nasi  upwards. 

Just  beneath  this  muscle  there  is  sometimes  a  fasciculus,  called  the 
Anomalus  Faciei  of  Albinus,  which  is  attached  by  one  end  to  the  os 
maxillare  superius  near  the  canine  fossa,  and  by  the  other  to  the 
upper  lip. 

The  Levator  Jlnguli  Oris 

Is  a  small  muscle,  concealed  very  much  by  the  last;  it  arises  from 
the  anterior  part  of  the  superior  maxillary  bone,  between  the  foramen 
infra-orbitarium  and  the  first  bicuspate  tooth,  and  is  inserted  into  the 
corner  of  the  mouth. 

It  raises  the  angle  of  the  mouth. 

The  Zygomaticus  Minor 

Is  a  small  muscle,  arising  from  the  fore  part  of  the  os  malse ;  it  de- 
scends obliquely,  and  is  inserted  into  the  upper  lip  just  above  the 
corner  of  the  mouth.1 

The  Zygomaticus  Major 

Is  just  on  the  outside  of  the  last,  and  is  much  larger.  It  arises 
from  the  malar  bone,  externally,  at  its  posterior  inferior  part,  just 
above  the  lower  edge,  where  this  bone  contributes  to  form  the  zygoma. 

1  Varieties.  Frequently  it  is  deficient;  sometimes  it  is  a  fasciculus  of  the  orbicularis 
oculi ;  sometimes  it  is  double ;  sometimes  it  does  not  reach  the  corner  of  the  mouth. 


374  MUSCLES. 

It  passes  obliquely  downwards  to  be  inserted  into  the  corner  of  the 
mouth,  and  runs  into  the  depressor  anguli  oris. 

The  last  two  muscles  draw  the  corner  of  the  mouth  towards  the 
cheek  bone,  or  obliquely  upwards  and  outwards,  as  in  smiling. 

The  Depressor  Labii  Superioris  et  Alse  Nasi 

Is  concealed  by  the  orbicularis  oris,  and  the  levator  labii  superioris 
et  alse  nasi.  To  get  a  view  of  it,  the  upper  lip  must  be  inverted,  and 
the  lining  membrane  of  the  mouth  removed  on  the  side  of  the  frsenum 
of  the  lip.  This  muscle  arises  from  the  inferior  part  of  the  upper 
maxilla  in  front  of  the  alveolar  processes  for  the  dens  caninus  and  the 
incisores,  and  is  inserted  into  the  side  of  the  ala  nasi,  and  into  the  con- 
tiguous part  of  the  upper  lip. 

It  depresses  the  upper  lip  and  the  ala  nasi. 

The  Depressor  Anguli  Oris 

Arises  broad  and  fleshy  from  the  base  of  the  lower  jaw  on  the  side 
of  the  chin  ;  being  somewhat  triangular,  its  apex  is  inserted  into  the 
corner  of  the  mouth. 

This  muscle  draws  the  corner  of  the  mouth  downwards.  It  lies  im- 
mediately under  the  skin,  and  blends  above  with  the  zygomaticus  major 
and  with  the  levator  anguli  oris. 

The  Depressor  Labii  Inferioris 

Is  in  part  beneath  the  last  muscle,  and,  like  it,  arises  broad  and 
fleshy  from  the  basis  of  the  lower  jaw  on  the  side  of  the  chin ;  its 
fibres  pass  obliquely  upwards  and  inwards,  and  are  inserted  into  the 
whole  side  of  the  lower  lip. 

It  draws  the  lip  downwards. 

These  last  two  muscles  are  much  obscured  by  being  mixed  with  a 
quantity  of  adipose  matter;  the  skin,  also,  is  closely  blended  with 
them,  and  the  roots  of  the  beard  penetrate  between  the  intervals  of 
their  fibres.1 

The  Levator  Menti,  or  Labii  Inferioris, 

Being  placed  beneath  the  depressor  labii  inferioris,  is  demonstrated 
by  turning  downwards  the  lower  lip  and  dissecting  away  its  lining  mem- 
brane on  the  side  of  the  freenum  ;  it  will  then  be  seen  to  arise  in  front  of 
the  alveolar  processes  of  the  external  incisor  and  the  canine  tooth,  and, 
passing  obliquely  downwards,  to  be  inserted  into  the  lower  lip. 

It  elevates  the  lower  lip. 

1  Varieties.    Its  exterior  border  is  often  formed  by  the  Platysma  Myoides. 


MUSCLES  OF  THE  FACE.  375 


The  Buccinator 

Arises  from  the  root  of  the  coronoid  process  of  the  lower  maxilla ; 
from  the  tuber  or  back  part  of  the  os  maxillare  superius  near  the 
pterygoid  process  of  the  sphenoid  bone,  and  from  the  roots  of  the 
alveolar  processes  of  both  the  upper  and  the  lower  maxillary  bone,  as 
far  forward  as  the  dentes  bicuspides.  It  is  inserted  into  the  corner  of 
the  mouth,  and  into  the  contiguous  parts  of  the  upper  and  lower  lips. 

It  draws  the  corner  of  the  mouth  directly  backwards. 

The  Orbicularis  Oris 

Is  a  circular  muscle  just  beneath  the  skin,  much  blended  with  adipose 
matter  externally,  but  more  plain  on  the  surface  contiguous  to  the 
lining  membrane  of  the  mouth.  It  constitutes  a  considerable  part  of 
the  thickness  of  the  lips,  and  surrounds  the  mouth  entirely.  It  has  no 
bony  origin,  but  arises  from  the  fibres  of  the  several  muscles  which  join 
each  other  at  the  corner  of  the  mouth,  and  therefore  consists  of  two 
semicircular  planes,  one  for  the  upper  and  the  other  for  the  lower  lip. 

It  is  the  antagonist  to  most  of  the  other  muscles  of  the  mouth.  From 
its  superior  part  a  pyramidal  slip  goes  to  the  tip  of  the  nose,  being 
called  by  Albinus,  Nasalis  Labii  Superioris. 

The  Massetcr. 

The  masseter  is  placed  between  the  skin  and  the  ramus  of  the 
lower  jaw ;  it  is  of  an  oblong  shape,  and  evidently  consists  of  two  por- 
tions, an  external  and  an  internal,  which  may  be  readily  recognized  by 
the  course  of  their  fibres,  inasmuch  as  they  decussate. 

As  a  whole,  it  arises,  tendinous  and  fleshy,  from  the  malar  process 
of  the  os  maxillare  superius ;  from  the  whole  inferior  edge  of  the  malar 
bone,  between  the  maxillary  and  the  zygomatic  sutures,  and  from  the 
zygomatic  process  of  the  temporal  bone.  Of  its  two  portions,  the  in- 
ternal is  the  smaller,  and  is  inserted  tendinous  into  the  outer  part  of 
the  root  of  the  coronoid  process  of  the  lower  jaw ;  while  the  external 
extends  from  its  origin  to  the  angle  and  contiguous  part  of  the  lower 
jaw,  where  it  is  inserted  tendinous  and  fleshy.  A  part  of  the  internal 
portion  may  be  seen  at  the  zygomatic  suture,  behind  the  external, 
without  the  latter  being  raised  up. 

Both  portions  have  the  power  to  close  the  jaws:  the  external  also 
draws  the  lower  jaw  forward,  and  the  internal  draws  it  backwards. 

The  Temporalis. 

The  temporal  muscle  is  placed  on  the  side  of  the  head,  and  occupies 
its  middle  inferior  region.  It  is  covered  externally  by  the  Fascia  Tem- 
poralis, a  thick,  dense,  tendinous  membrane;  which  arises  by  the  whole 
length  of  the  parietal  ridge  on  the  side  of  the  cranium,  and  is  inserted 
into  the  upper  margin  of  the  zygoma,  as  formed  by  the  malar  bone  and 
the  zygomatic  process  of  the  temporal. 

The  temporal  muscle  arises  from  the  inner  face  of  this  fascia ;  from 


37-6  MUSCLE& 

the  whole  length  of  the  semicircular  ridge  on  the  side  of  the  os  frontis 
and  parietale;  and  from  the  surface  of  the  cranium  between  this  ridge 
and  the  zygoma,,  including  the  part  contributed  by  the  frontal  bone, 
the  parietal,  the  squamous  portion  of  the  temporal,  and  the  sphenoid. 
This  muscle  also  receives  an  accession  of  fleshy  fibres  from  the  internal 
face  of  the  zygoma. 

From  this  extensive  origin  the  fibres  converge  towards  the  zygoma, 
and  passing  beneath  it,  are  inserted  tendinous  into  the  coronoid  pro- 
cess of  the  lower  jaw,  so  as  to  surround  it  on  every  side;  some  of  these 
tendinous  fibres  go  down  in  front  almost  to  the  last  dens  molaris. 

It  pulls  the  lower  jaw  directly  upwards. 

The  Pterygoideus  Externus. 

The  external  pterygoid  muscle,  so  called  from  its  position,  arises 
fleshy  from  the  outer  face  of  the  external  pterygoid  process  of  the 
sphenoid  bone,  and  from  the  adjoining  surfaces  of  the  same  bone  by 
its  spinous  and  temporal  processes ;  also  from  the  tuber  of  the  upper 
maxillary. 

It  passes  outwards  and  backwards  horizontally,  and  is  inserted  into 
the  inner  side  of  the  neck  of  the  inferior  maxilla;  into  the  inter-articular 
cartilage,  and  into  the  capsular  ligament  of  the  articulation. 

When  the  muscles  of  the  opposite  sides  act  together,  they  draw  the 
lower  jaw  forwards,  but  if  alternately,  they  give  it  a  grinding  motion.1 

The  Pterygoideus  Internus. 

The  internal  pterygoid  muscle  arises  by  tendinous  and  fleshy  fibres 
from  the  internal  pterygoid  process  of  the  sphenoid  bone,  along  the 
outer  margin  of  the  Eustachian  tube,  and  from  the  greater  part  of  the 
pterygoid  fossa.  Passing  downwards  and  backwards,  it  is  inserted 
tendinous  and  fleshy  into  the  internal  face  of  the  angle  of  the  lower 
jaw. 

When  the  muscles  of  the  opposite  sides  act,  they  close  the  jaw, 


SECT.  II. — MUSCLES  OF  THE  NECK. 

Of  the  Fascia  Superficialis  Oolli. 

Between  the  skin  of  the  neck  and  its  superficial  muscles,  may  be 
observed  a  layer  of  compact  cellular  substance,  the  consistence  of 
which  is  more  strongly  developed  in  some  subjects  than  in  others.  It 
is  the  continuation  of  the  same  membrane  which  is  spread  upon  the 
extern ali  abdominal  muscles,  and  is  called  there  the  Fascia  Superficialis 
Abdominis.  Passing  from  the  abdomen  over  the  thorax,  it  adheres  to 
the  clavicles  and  sternum,  but  not  very  strongly ;  it  then  goes  from 
them  over  the  neck  to  the  face,  being  slightly  fastened  to  the  base  of 
the  lower  jaw,  in  advance  of  the  masseter  muscle. 

1  Varieties.  I  have  seen,  in  one  case,  this  muscle  continued  into  the  inferior  margin  of 
the  temporal. 


MUSCLES  OF  THE  NECK.  377 

It  is  spread  over  the  submaxillary  and  parotid  glands ;  is  in  many 
subjects  strongly  marked  there  by  its  fibrous  character,  and  sends 
down  partitions  between  their  lobules,  as  well  as  between  the  muscles 
and  their  fasciculi,  thereby  forming  sheaths  for  the  same.  By  these 
partitions  it  communicates  with  the  fascia  profunda  colli.  Above  it  is 
fixed  to  the  mastoid  process ;  to  the  meatus  auditorius  externus,  and  to 
the  zygoma.  Just  above  the  latter  it  adheres  to  the  fascia  temporalis, 
and  a  thin  layer  of  fat  intervenes  between  them.  This  fascia  is  more 
strongly  characterized  about  the  parotid  gland  and  lower  jaw  than  else- 
where. It  is  remarkably  distinct  in  the  foetus  at  full  time,  the  sheaths, 
which  it  forms  for  the  muscles,  being  then  very  clear  of  adipose  mat- 
ter, and  semi-diaphanous. 

The  Platysma  Myoides, 

Or  the  Musculus  Cutaneus,  lies  upon  the  fascia  superficialis,  or 
rather  is  included  between  two  laminae  of  it,  one  above  and  the  other 
below,  forming  its  sheath,  which  is  very  thin,  especially  on  the  side 
next  to  the  skin.  This  muscle  covers,  by  its  breadth,  a  very  consider- 
able portion  of  the  side  of  the  neck,  and  extends,  obliquely,  from 
the  thorax  to  the  face. 

It  arises  in  the  condensed  cellular  membrane  on  the  upper  part  of 
the  pectoralis  major  muscle,  and  of  the  deltoid,  just  below  the  clavicle, 
nearly  the  whole  length  of  this  bone.  Its  fibres  are  much  more  pale 
than  those  of  other  voluntary  muscles ;  are  collected  into  longitudinal 
fasciculi,  constituting  a  plane  of  scarcely  a  line  in  thickness,  and  ter- 
minate in  the  integuments  of  the  lower  jaw  and  of  the  cheek.  It  is 
attached  to  the  lower  jaw  just  in  advance  of  the  masseter  muscle,  and 
is  sometimes  inserted  for  a  considerable  distance  along  the  base  of  the 
same  bone.  It  not  unfrequently  runs  into  the  muscles  of  the  lower 
part  of  the  face. 

When  the  whole  muscle  is  in  action,  it  elevates  the  skin  of  the  neck. 
The  external  jugular  vein  is  seen  running  nearly  in  the  centre  of  it, 
in  the  same  direction  with  the  fibres  of  this  muscle,  and  between  it  and 
the  sterno-cleido-mastoid.1 

Upon  the  upper  part  of  this  muscle  there  is  occasionally  a  thin 
distinct  plane  of  fibres  crossing  it  and  running  into  the  depressor 
anguli  oris.  This  is  the  Musculus  Risorius  of  Santorini. 

The  Sterno-Cleido-Mastoideus 

Is  beneath,  and  decussates  the  last  muscle.  It  forms  always  a 
prominent  feature  in  the  outline  of  the  neck,  in  passing  obliquely  from 
the  upper  front  part  of  the  thorax  to  the  base  of  the  cranium. 

It  arises  tendinous  from  the  edge  of  the  upper  end  of  the  sternum, 
and  tendinous  and  fleshy  from  the  sternal  end  of  the  clavicle.  These 
origins  are  separated  by  a  considerable  fissure  ;  but  they  soon  unite  by 
the  clavicular  portion,  crossing  below  the  sternal. 

1  Varieties.  In  some  rare  instances  this  muscle  has  been  found  thick  and  round  ;  and  in- 
stead of  going  towards  the  face,  inserted  into  the  occiput. 


378  MUSCLES. 

It  is  inserted  tendinous  into  the  mastoid  process,  and  into  the  part  of 
the  superior  transverse  ridge  of  the  cranium  next  to  it. 
It  draws  the  chin  towards  the  sternum.1 

Of  the  Fascia  Profunda  Colli. 

When  the  origin  of  the  sterno-cleido-mastoideus  is  turned  to  one 
side,  the  Fascia  Profunda  of  the  neck  is  seen  beneath  the  fascia  super- 
ficialis,  and  somewhat  separated  from  it  by  a  lamina  of  cellular  adi- 
pose matter.  This  membrane  arises  from  the  larynx,  forms  a  thin 
capsule  to  the  thyroid  gland,  and,  being  closely  attached  to  its  inferior 
margin,  descends  by  investing  the  sterno-hyoid  and  thyroid  muscles,  be- 
ing well  seen  on  their  anterior  surfaces.  It  is  firmly  fastened  to  the  upper 
edge  of  the  sternum,  to  the  sternal  end  of  the  clavicles,  and  to  the  carti- 
lages of  the  first  pair  of  ribs,  forming  an  elastic  and  resisting  membrane 
from  the  larynx  to  the  thorax.  By  turning  off  the  sterno-hyoid  and 
thyroid  muscles  from  their  attachment  to  the  sternum,  the  fascia  pro- 
funda  will  be  seen  still  more  distinctly,  passing  behind  them  from  the  infe- 
rior margin  of  the  thyroid  gland  to  the  upper  bone  of  the  sternum :  this 
lamina  of  it  is  inserted  into  the  sternum,  twelve  or  fifteen  lines  below  the 
upper  edge.  It  encloses  or  surrounds  the  transverse  vein  and  the  arteria 
innominata.  Beneath  the  fascia  profunda,  are  the  trachea,  the  roots  of  the 
arteries  of  the  head  and  upper  extremities  and  the  trunks  of  their  veins. 
There  is  much  loose  cellular  and  adipose  matter  placed  at  the  lower  part 
of  the  neck, beneath  this  fascia,  and  between  it  and  the  trachea;  through 
which  the  thyroid  veins  with  their  ramifications  pass.  This  last  circum- 
stance must  always  render  suppurations  and  operations  in  the  part  high- 
ly dangerous,  as  the  pus  will  form  fistulous  passages  under  the  sternum  ; 
moreover,  the  continual  motion  of  the  part  in  respiration  prevents 
adhesions,  and,  therefore,  disposes  to  ulceration.  An  ingenious  idea 
on  the  uses  of  this  fascia,  and  of  the  sterno-hyoid  and  thyroid  muscles 
as  connected  with  it,  was  suggested  by  the  late  Allan  Burns  :  he  con- 
ceived that  they  were  a  defence  to  the  upper  part  of  the  thorax,  and 
sustained,  in  inspiration,  the  atmospheric  pressure,  which,  without 
them,  would  fall  upon  the  trachea  and  produce  difficulty  of  breathing, 
from  the  air  not  passing  through  the  larynx  rapidly  enough  to  keep 
pace  with  the  dilatation  of  the  thorax.  He  illustrates  the  opinion  by  a 
case  very  much  in  point,  of  a  gentleman  who  had  lost  this  fascia  and 
the  muscles  by  suppuration,  and  who  was  afterwards  incommoded  by 
atmospheric  pressure  upon  the  trachea  at  this  place.2  M.  Velpeau, 
on  the  contrary,  asserts  that  cutting  through  it  in  opening  abscesses 
and  operations,  has  no  such  consequence.3 

1  Varieties.  Sometimes  a  fasciculus,  at  its  posterior  margin,  is  presented  in  a  state  entire- 
ly insulated.  Occasionally,  its  lower  extremity  has  been  observed  to  reach  as  far  as  the 
rectus  abdominis  muscle,  and  even  to  the  point  of  the  third  bone  of  the  sternum.  The 
fissure  between  the  sternal  and  clavicular  portions  in  mammiferous  animals,  is  naturally,  so 
much  extended  as  to  produce  two  distinct  muscles. 

'2  The  late  Dr.  Lawrence  informed  me  that  the  fascia  profunda  is  well  developed  in-  the 
neck  of  a  cat,  and  that,  having  occasion  to  remove  it  in  an  experiment,  the  respiration  of 
the  animal  was  conducted  with  great  difficulty,  amounting  almost  to  suffocation.  This  is  a 
good  confirmation  of  Mr.  Burns's  hypothesis.  When  lymphatic  or  scirrhous  tumors  are 
evolved  behind  the  upper  end  of  the  sternum,  this  fascia  forces  them  against  the  trachea  and 
thus  produces  a  distressing  impediment  to  respiration. 

3  Anat.  Chir.  vol.  i.  p.  438,  2d  edit. 


MUSCLES  OF  THE  NECK.  379 

The  external  border  of  the  fascia  profunda  is  continued  into  the 
sheath  of  the  great  vessels  of  the  neck.  It  and  the  fascia  superficialis 
are  also  continuous  with  one  another  along  the  anterior  edge  of  the 
sterno-cleido-tnastoideus. 

Within  the  inferior  maxilla,  at  its  angle,  a  ligamentous  expansion 
arises  at  the  pterygoideus  externus  muscle,  and  is  spread  out  between 
the  styloid  process  and  the  ramus  of  the  lower  jaw.  This  membrane, 
described  as  the  stylo-maxillary  ligament,  is  joined  at  its  inferior  edge 
by  the  fascia  superficialis,  just  before  the  upper  part  of  the  sterno- 
mastoideus,  and  which  increases  its  breadth  downwards  in  the  neck, 
giving  it  somewhat  the  condition  of  a  vertical  septum  of  that  region: 
at  its  lower  edge  it  runs  into  the  sheath  of  the  great  vessels  of  the  neck. 
Through  its  lower  part,  penetrate  the  stylo-hyoideus  and  the  digastricus 
muscles,  and  the  upper  part  separates  the  parotid  from  the  submaxillary 
gland.  It  is  felt  like  a  cord,  extending  downwards  and  backwards 
below  the  angle  of  the  maxilla  inferior.  It  is  connected  at  its  internal 
edge  with  the  nerves  and  vessels  of  the  part,  in  such  a  manner  as  to 
forbid  description;  but  the  practical  anatomist  will  find  no  difficulty  in 
discovering  and  understanding  it. 

Below  this  septum,  a  round  ligament,  (the  stylo-hyoid,}  like  a  nerve, 
passes  from  the  extremity  of  the  styloid  process  to  the  appendix  of  the 
os  hyoides.  It  varies  very  much  in  its  size,  in  some  being  merely  a 
fine  thread,  which  is  almost  lost  below. 

The  fascia  profunda  colli  is  also  well  marked  in  the  foetus,  and  not 
much  blended  with  adipose  matter.  It,  like  the  fascia  superficialis,  is 
only  a  sheath  for  the  muscles  which  it  surrounds,  and  is  called  fascia 
from  having  some  development  of  fibrous  matter  in  its  substance. 

The  Sterno-Hyoideus 

Arises  thin  and  fleshy  on  the  interior  of  the  thorax  from  the  approxi- 
mated surfaces  of  the  cartilage  of  the  first  rib,  the  clavicle,  and  the 
first  bone  of  the  sternum ;  it  passes  upwards  somewhat  obliquely,  and 
is  inserted  into  the  inferior  edge  of  the  base  of  the  os  hyoides.  Its 
lower  ejad  is  covered  by  the  sterno-mastoideus. 

It  draws  the  os  hyoides  towards  the  sternum.1 

The  Sterno-Thyroideus 

Is  beneath  the  last,  and  concealed,  in  a  considerable  degree,  by  it. 
It  arises  fleshy  from  the  interior  surface  of  the  sternum,  about  an  inch 
below  its  upper  margin,  and  from  the  cartilage  of  the  first  rib ;  dimin- 
ishing somewhat  in  breadth,  as  it  ascends,  it  is  inserted  obliquely  into 
the  side  of  the  thyroid  cartilage. 

It  draws  this  cartilage  towards  the  sternum.3 

1  Varieties.     Sometimes  it  arises  from  the  middle  of  the  clavicle;  it  is  double,  or  is  con- 
founded below  with  the  next  muscle. 

2  Varieties.     Sometimes  there  are  two  of  these  muscles,  one  placed  above  the  other; 
sometimes  it  runs  into  the  inferior  constrictor  of  the  pharynx;  sometimes   it  runs  into  the 
posterior  margin  of  the  thyro-hyoid  muscle;  sometimes  the  muscle  on  one  side   is  united  to 
the  other  by  transverse  fibres.     I  have,  in  one  instance,  Jan.  1, 1839,  seen  a  slip  at  the  exter- 
nal margin  of  this  muscle,  which,  arising  from  the  cartilage  of  the  first  rib,  ascended  in  front 
of  the  great  vessels,  and  was  inserted  into  their  sheath  on  a  level  with  the  thyroid  cartilage 


380  MUSCLES. 

The  Thyro  or  Thyreo-Hyoidem 

Arises  obliquely  from  the  side  of  the  thyroid  cartilage  externally, 
and  is  inserted  into  a  part  of  the  base,  and  into  the  anterior  half  of  the 
cornu  of  the  os  hyoides.  It  seems  almost  like  a  continuation  of  the 
Sterno-Thyroideus. 

Its  use  is  to  approximate  the  os  hyoides  and  the  thyroid  cartilage, 
in  doing  which  it  has  the  effect  of  planting  the  epiglottis  against  the 
root  of  the  tongue,  and  of  drawing  the  cricoid  and  the  arytenoid  carti- 
lages against  it,  so  that  the  opening  of  the  glottis  is  protected.1 

The  Omo-Hyoidem 

Passes  obliquely  across  the  neck,  from  the  superior  edge  of  the 
scapula  to  the  os  hyoides.  It  is  a  thin,  narrow  muscle,  divided  into 
two  bellies,  one  at  each  end,  by  an  intermediate  tendon ;  its  inferior 
part  is  concealed  by  the  trapezius  muscle  ;  its  middle,  where  the  tendon 
exists,  crosses  'the  great  vessels  of  the  neck,  and  is  covered  by  the 
sterno-cleido-mastoid  muscle  ;  and  its  upper  extremity  is  overlapped  by 
the  platysma  myoides. 

It  arises  from  the  scapula  just  behind  the  coracoid  notch  in  its 
superior  costa,  and  curving  somewhat  downwards  in  its  course,  it  is 
inserted  into  the  lower  edge  of  the  base  of  the  os  hyoides,  next  to  its 
cornu. 

It  draws  the  os  hyoides  downwards.2 

The  Digastricus 

Is  placed  at  the  upper  side  of  the  neck,  and  passes  from  the  back 
part  of  the  base  of  the  head  to  the  chin. 

It  arises  principally  fleshy  from  the  fossa  of  the  temporal  bone  at 
the  base  of  the  mastoid  process;  its  middle  is  converted  into  a  round 
tendon,  which  passes  through  the  stylo-hyoideus  muscle,  and  is  fixed 
by  a  ligamentous  loop  or  expansion  to  the  cornu  of  the  os  hyoides. 
After  which  another  fleshy  belly  is  formed,  which  is  inserted  into  the 
inside  of  the  base  of  the  maxilla  inferior,  at  the  side  of  its  symphysis. 
It  receives  an  accession  from  the  base  of  the  os  hyoides. 

Its  use  is  to  draw  the  os  hyoides  upwards  when  its  extremities  are 
fixed,  and,  as  Mr.  Hunter  has  pointed  out,  to  throw  the  head  backwards, 
and  thereby  to  open  the  mouth,  when  the  lower  jaw  is  fixed  upon  a 
body  of  the  same  height.3 

1  Varieties.     Its  fibres  sometimes  run  into  those  of  the  middle  constrictor  of  the  pharynx; 
sometimes  they  arise  from  the  cricoid  cartilage;  sometimes  it  is  continuous  with  the  sterno- 
thyroideus. 

2  Varieties.    Sometimes  it  is  double,  so  that  besides  the  usual  insertion,  it  has  one  into  the 
side  of  the  tongue. 

3  A  common  variety  in  this  muscle  consists  in  the  mutual  adhesion  of  the  two  anterior 
bellies  belonging  to  the  opposite  sides,  showing  thereby  a  marked  tendency  to  the  quadruped 
arrangement. 


MUSCLES  OF  THE  NECK.  881 

The  Stylo- Ilyoideus 

Is  the  more  superficial  of  the  three  styloid  muscles.  It  arises  ten- 
dinous from  the  middle  and  inferior  part  of  the  styloid  process  of  the 
temporal  bone  ;  and  being  perforated,  as  mentioned  by  the  tendon  of 
the  digastricus.  is  inserted  tendinous  into  the  cartilaginous  juncture  of 
the  base  and  cornu  of  the  os  hyoides. 

It  draws  the  os  hyoides  upwards  and  backwards.1 

The  Stylo- Crlossus 

Is  within  and  above  the  other ;  it  arises  from  the  upper  internal 
part  of  the  styloid  process,  tendinous  and  fleshy,  and  is  inserted  into 
the  side  of  the  root  of  the  tongue,  forming  a  part  of  its  structure.2 

It  draws  the  tongue  backwards.3 

The  Stylo- Pharyngeus 

Is  more  deeply  situated  than  either  of  the  other  two  muscles.  It 
arises  from  the  inner  side  of  the  styloid  process  near  its  root,  and  runs 
into  the  side  of  the  pharynx  between  the  middle  and  upper  constrictors, 
opposite  the  tonsil  gland ;  it  afterwards  descends  between  the  lining 
membrane  of  the  pharynx  and  the  middle  and  the  lower  constrictor, 
and  is  inserted  into  the  posterior  margin  of  the  thyroid  cartilage. 

It  draws  the  larynx  and  pharynx  upwards. 
/ 

The  Mylo-Hyoideus 

Forms  the  floor  of  the  mouth  and  suspends  the  tongue  ;  it  arises  at 
the  root  of  the  alveolar  processes  of  the  lower  jaw,  from  a  ridge  ex- 
tending from  the  last  dens  molaris  to  the  chin.  Its  fibres  converge 
towards  a  white  tendinous  line,  placed  between  it  and  its  fellow,  and 
reaching  from  the  base  of  the  os  hyoides  to  the  chin,  they  are  in  that 
way  inserted  into  the  congeneric  fibres  of  the  opposite  side.  This 
muscle  is  concealed  by  the  anterior  belly  of  the  digastricus.  When  it 
contracts,  it  draws  the  os  hyoides  upwards  and  projects  the  tongue.4 

The  G-enio- Ilyoideus 

Is  concealed  by  the  last ;  by  turning  over  the  anterior  edge  of  which, 
it  is  seen.  It  arises  tendinous  from  the  posterior  mental  tubercle  on 
the  inside  of  the  symphysis  of  the  lower  jaw  ;  and,  increasing  somewhat 
in  breadth,  is  inserted  into  the  anterior  part  of  the  base  of  the  os 
hyoides. 

It  draws  the  os  hyoides  upwards  and  forwards.5 

1  Varieties.     This  muscle  is  frequently  double. 

2  See  Tongue. 

3  Varieties.    J.  F.  Meckel  says  that  on  one  occasion  he  found  it  double  on  both  sides. 

4  Varieties.     Sometimes  a  part  of  it  is  inserted  into  the  middle  tendon  of  the  digastricus, 
or  is  joined  with  the  sterno-hyoideus. 

5  Varieties.    Sometimes  a  distinct  fasciculus  of  this  muscle  is  inserted  into  the  greater  part 
of  the  cornu  of  the  os  hyoiJes.     Sometimes  there  is  but  one  muscle.     Rarely  it  is  double  on 
both  sides. 


382  MUSCLES. 

(For  the  muscles  of  the  tongue,  see  Mouth.) 

There  are  several  pairs  of  muscles  on  the  front  and  sides  of  the  cer- 
vical vertebrae  which  lie  closely  upon  them.  They  are  named  from 
their  situations  and  shapes. 

1.   The  Longus  Colli. 

The  longus  colli  is  next  to  the  middle  line  of  the  vertebras.  It 
arises  from  the  sides  of  the  bodies  of  the  three  superior  vertebrae  of  the 
back,  and  from  the  anterior  edges  of  the  transverse  processes  of  the 
five  lower  cervical  vertebrae.  Its  fibres  pass  somewhat  obliquely  up- 
wards and  inwards,  to  be  inserted  into  the  front  of  the  bodies  of  all  the 
cervical  vertebrae. 

It  bends  the  neck  forwards,  and  to  one  side.1 


25 


A  lateral  view  of  the  Deep-seated  Muscles  of  the  Face  and  Neck.— 1.  The  inferior  maxillary  bone. 
2.  Superior  maxillary  bone.  3.  Malar  bone.  4,  4.  Orbicularis  oris  muscle.  5.  Buccinator.  6.  Ex- 
ternal pterygoid.  7.  Internal  pterygoid.  8.  Glenoid  cavity.  9.  Constrictor  pharyngis  superior. 
10.  Mastoid  portion  of  the  temporal  bone.  11.  Splenius.  12.  Stylo-pharyugeus.  13.  Stylo-glossus. 
14.  Constrictor  pharyngis  medius.  15.  Longus  colli.  16.  Scalenus  medius.  17.  Levator  scapula. 
18.  Serratus  superior  posticus.  19.  Scalenus  anticus.  20.  Scalenus  posticus.  21.  Rhomboideus 
minor.  22.  Cut  surface  of  trapezius.  23.  Supra-spinatus.  24.  Acromion  scapula3.  25.  First  rib. 
26.  Sterno-clavicular  articulation.  27.  Clavicle.  28.  Trachea.  29.  (Esophagus.  30.  Crico-thyroi- 
deus.  31.  Constrictor  pharyngis  inferior.  32.  Thyro-hyoid.  33.  Thyro-hyoid  ligament.  34.  Os 
hyoidee.  35.  Hyo-glossus.  36.  Myo-hyoid. 

2.   The  Rectus  Capitis  Anticus  Major 

Is  placed  on  the  outside  of  the  last.  It  arises  tendinous  and  fleshy 
from  the  fronts  of  the  transverse  processes  of  the  third,  fourth,  fifth, 
and  sixth  cervical  vertebrae ;  forms  a  considerable  fleshy  belly,  and  is 

1  Varieties.  Sometimes  a  fasciculus  from  the  first  or  second  rib,  or  from  the  body  of  the 
sixth  or  seventh  vertebra  of  the  neck,  joins  it. 


MUSCLES  OF  THE  NECK.  383 

inserted  into  the  cuneiform  process  of  the  os  occipitis,  just  before  the 
condyle. 

It  bends  the  head  forwards.1 

3.   The  Rectus  Capitis  Anticus  Minor. 

This  is  a  very  small  muscle.  It  arises  fleshy  from  the  front  of  the 
first  cervical  vertebra  near  its  transverse  process,  and  is  inserted  under 
the  rectus  major  before  the  root  of  the  condyloid  process  of  the  occi- 
pital bone. 

It  bends  the  head  forwards. 

\ 

4.   The  Rectus  Capitis  Lateralis. 

This  is  also  small,  and  arises  fleshy  from  the  front  of  the  transverse 
process  of  the  atlas.  It  is  inserted,  tendinous  and  fleshy,  at  the  out- 
side of  the  condyle  of  the  occipital  bone,  into  the  ridge  leading  from  it 
to  the  mastoid  process. 

It  pulls  the  head  a  little  to  one  side.2 

5.   The  Scalenus  Prior,  or  Jinticus. 

The  scalenus  anticus  arises  by  three  distinct  tendinous  heads  from 
the  transverse  process  of  the  fourth,  fifth,  and  sixth  cervical  vertebrae, 
and  is  inserted  tendinous  and  fleshy  in  the  upper  surface  of  the  first 
rib,  just  anteriorly  to  its  middle. 

6.  The  Scalenus  Medius. 

The  scalenus  medius  arises  by  distinct  tendons  from  the  transverse 
processes  of  all  the  cervical  vertebrae,  and  is  inserted  tendinous  and 
fleshy  into  the  upper  face  of  the  first  rib,  in  all  the  space  from  its  mid- 
dle to  its  tubercle. 

7.  The  Scalenus  Posticus. 

The  scalenus  posticus  arises  from  the  transverse  process  of  the  fifth 
and  sixth  cervical  vertebrae,  and  is  inserted  into  the  upper  face  of  the 
second  rib,  just  beyond  its  tubercle. 

The  last  three  muscles  are  concealed  by  the  sterno-cleido-rnastoideus 
and  the  anterior  edge  of  the  trapezius.  The  scalenus  posticus  is  best 
seen  in  dissecting  the  muscles  of  the  spine,  and  resembles  very  much 
one  of  the  class  to  which  Albinus  gives  the  name  of  Levatores  Cos- 
tarum. 

All  the  Scaleni  elevate  the  ribs  and  bend  the  neck  to  one  side.  They 
are  particularly  interesting  as  connected  with  the  course  of  the  large 
blood-vessels  and  nerves  of  the  upper  extremity.3 

1  Sometimes  it  also  arises  from  the  first  and  second  vertebra*. 

2  Varieties.     Sometimes  another  muscle  arises  from  the  body  of  the  first  vertebra  of  the 
neck. 

3  Varieties.     Besides  the  three  scaleni  which  are  described,  there  are  frequently  supernu- 
merary muscles  or  fasciculi.    One  of  these,  called  the  Scalenus  Minimus  Albiui,  is  between 


384  MUSCLES. 


CHAPTER   II. 

MUSCLES  OF  THE  TRUNK. 

SECT.  I.— MUSCLES  ON  THE  FRONT  OF  THE  THORAX. 

The  Pectoralis  Major 

Is  superficial,  and  forms  the  large  swelling  cushion  of  flesh  under  the 
skin  of  the  breast.  It  arises  tendinous  and  fleshy  from  the  anterior  face 
of  the  first  two  bones  of  the  sternum,  their  whole  length ;  fleshy  from 
the  cartilage  of  the  fifth  and  the  sixth  ribs,  and  by  a  fleshy  slip  from  the 
upper  part  of  the  tendon  of  the  external  oblique  muscle.  It  arises, 
also,  fleshy  from  the  sternal  two:thirds  of  the  clavicle.  The  clavicular 
and  sternal  portions  of  the  origin  are  separated  by  an  interval,  giving 
the  appearance  of  two  muscles. 

The  fibres  converge,  and  terminate  by  a  broad,  thin  tendon,  which 
is  inserted  into  a  roughness  on  the  exterior  edge  of. the  bicipital  fossa 
of  the  os  humeri,  and  into  the  fascia  brachialis,  just  at  the  internal  edge 
of  the  deltoid  muscle.  At  this  insertion  it  adheres  to  the  tendon  of  the 
latissimus  dorsi.  The  under  edge  of  the  muscle,  near  its  insertion,  is 
folded  inwards  and  upwards,  which  gives  the  rounded  thick  margin  to 
the  fore  part  of  the  axilla.  That  part  of  the  broad  tendon  belonging 
to  the  clavicular  portion  is  inserted  lower  down  than  the  sternal,  which 
produces  a  decussation  of  the  fibres  of  the  tendon. 

The  pectoralis  major  draws  the  arm  inwards  and  forwards ;  and  also 
depresses  it  when  it  is  raised.1 

The  Pectoralis  Minor 

Is  brought  into  view  by  raising  the  last  muscle.  It  is  comparatively 
small,  and  somewhat  triangular.  Arising  by  thin  tendinous  digitations 

the  first  two,  and  occasionally  appears  as  a  fasciculus  of  the  scalenus  anticus,  separated  from  it 
by  one  or  more  of  the  brachial  nerves ;  it  is  sometimes  double.  Another  fasciculus,  called 
the  Scalenus  Lateralis,is  between  the  scalenus  mediusand  posticus;  it  comes  from  the  trans- 
verse process  of  the  fourth,  fifth,  and  sixth  vertebrae,  and  is  inserted  into  the  posterior  part  of 
the  first  rib. 

1  Varieties.  Sometimes  a  single  fasciculus  arises  from  the  eighth  rib,  which  ascends  to- 
wards the  os  humeri,  has  a  tendon  in  its  centre,  and  finally  joins  with  the  tendon  of  the  pec- 
toralis minor; — sometimes  this  muscle  detaches  a  small  fasciculus  to  the  brachialis  inter- 
ims;— sometimes  there  is  a  small  square  plane  of  muscular  fibres  on  its  front  surface,  decus- 
sating the  fibres  at  right  angles :— sometimes  a  fasciculus  almost  cylindrical  proceeds  from  it 
towards  the  axilla,  and,  being  changed  into  a  long  tendon,  is  inserted  into  the  internal  tube- 
rosity  of  the  os  humeri.  Supernumerary  fasciculi  are  also  found  going  from  one  rib  to  ano- 
ther, or  towards  the  sternum ;  sometimes  its  tendon  detaches  a  fasciculus,  which,  crossing 
the  insertion  of  the  muscle,  covers  the  bicipital  groove  of  the  os  humeri  like  a  bridge,  is 
blended  with  the  tendon  of  the  supra-spinatus,  and  increases  the  thickness  of  the  capsular 
ligament  of  the  shoulder  joint.  In  a  muscular  male  black  subject,  it  was  entirely  deficient, 
except  the  external  clavicular  half.  The  pectoralis  minor  was  wholly  wanting  in  the  same. 
Deer.  1837. 


MUSCLES  OF  THE  NECK.  385 

from  the  upper  edge  of  the  third,  fourth,  and  fifth  ribs,  it  soon  becomes 
fleshy,  and  is  inserted,  by  a  short  flat  tendon,  into  the  inner  facet  of 
the  coracoid  process  of  the  scapula. 

Its  use  is  to  draw  the  scapula  inwards  and  downwards.1 

The  Subclavius 

Is  a  small  muscle,  pla'ced  immediately  under  the  clavicle.  It  arises 
from  the  cartilage  of  the  first  rib,  and  is  inserted  into  the  inferior  face 
of  the  clavicle,  from  near  the  sternum,  to  the  conoid  ligament,  which 
connects  the  coracoid  process  and  the  clavicle  together. 

It  draws  the  clavicle  downwards.* 

The  Serratus  Magnus,  or  Serratus  Major  Anticus, 

Is  a  broad  muscle,  lying  on  the  sides  of  the  ribs,  between  them  and 
the  scapula,  and  beginning  at  a  line  anterior  to  their  middle.  It  arises 
from  the  nine  upper  ribs  by  fleshy  digitations,  the  superior  one  of 
which  seems  almost  like  a  distinct  muscle  ;  the  five  lower  are  connected 
to  the  obliquus  exterHus  abdominis,  the  digitations  of  the  two  muscles 
interlocking  with  each  other.  The  fibres  converge,  and  are  inserted 
into  the  base  of  the  scapula  its  whole  length. 

Its  action  is  to  draw  the  scapula  forwards.3 

The  Interco&tale* 

Fill  up  the  spaces  between  the  ribs,  and  have  much  tendinous  matter 
running  in  the  interstices  of  their  fibres  and  in  the  same  line  with  them. 
There  are  two  in  each  space,  of  which  the  External  arises  from  the 
transverse  process  of  the  vertebra,  and  from  the  inferior  acute  edge  of 
the  rib  above,  from  its  head  almost  to  its  cartilage,  and  is  inserted  into 
the  superior  rounded  edge  of  the  rib  below  for  the  same  distance,  its 
fibres  passing  obliquely  forwards  and  downwards.  The  Internal  inter- 
costal arises  from  the  inferior  edge  of  the  rib  and  the  costal  cartilage 
above,  beginning  at  the  sternum,  and  extends  backwards  to  the  angle 
of  the  rib;  it  is  inserted  into  the  superior  rounded  edge  of  the  rib  and 
costal  cartilage,  below,  on  its  inner  side,  its  fibres  passing  obliquely 
backwards  and  downwards. 

They  draw  the  ribs  together. 

1  Varieties.     Sometimes  it  sends  a  fleshy  fasciculus  to  the  tendinous  origin  of  the  coraco- 
brachialis.     Sometimes, below  it,  there  is  a  third  pectoral  muscle,  which  arises  from  the  first 
and  second  rib,  and  is  inserted  into  the  coracoid  process ;  whereby  a  striking  analogy  with 
birds  is  established.     Another  variety  has  also  been  observed  in  the  existence  of  a  fasciculus, 
which  comes  from  the  upper  rib,  and  which,  covered  by  the  little  pectoral  muscle,  is  inserted 
into  the  capsular  ligament  of  the  scapulo-humeral  articulation. 

2  Varieties.    Sometimes  two  muscles  exist;  a  bursa  mucosa  is  formed  between  its  tendon 
and  the  cartilage  of  the  first  rib. 

9  Varieties.  Sometimes,  it  has  ten  or  eleven  origins;  the  upper  origin  is  deficient ;  the 
latter  is  so  distinct  that  it  may  pass  for  a  particular  muscle ;  a  wide  gap  exists  in  the  middle 
of  the  muscle,  dividing  it  into  two  distinct  parts. 

VOL.  I.— 25 


386  MUSCLES. 

The  Triangularis  Sterni 

Is  on  the  posterior  or  cardiac  face  of  the  cartilages  of  the  ribs,  and 
arises  from  the  whole  length  of  the  cartilago  ensiformis  at  its  edge,  and 
from  the  inferior  half  of  the  edge  of  the  second  bone  of  the  sternum. 
The  fibres  go  obliquely  upwards  and  outwards,  to  be  inserted  into  the 
cartilage  of  the  third,  fourth,  fifth  and  sixth  ribs  by  fleshy  and  tendi- 
nous digitations. 

Its  use  is  to  depress  the  ribs,  and,  consequently,  to  diminish  the 
cavity  of  the  thorax. 

This  muscle  is  frequently  defective  or  redundant  in  the  number  of 
its  heads,  and  is  commonly  more  or  less  continuous  with  the  transver- 
salis  abdominis ;  but  occasionally  it  is  so  much  so  that  the  two  seem  to 
make  but  one  muscle,  and  have,  therefore,  been  called  Sterno-abdomi- 
nalis,  by  Rosenmuller. 


SECT.  II. — MUSCLES  AND  FASCLE  OF  THE  ABDOMEN. 

Between  the  most  superficial  of  the  abdominal  muscles,  which  is  the 
external  oblique,  and  the  skin  with  the  subcutaneous  fat,  is  found  the 
Fascia  Superficialis  Abdominis.  In  lean  subjects  it  is  very  distinct, 
but  in  fat  ones  not  so  much  so,  from  being  blended  with  adipose  mat- 
ter. The  laminae  of  it  which  are  next  to  the  muscles,  are  kept,  in  the 
latter  case,  rather  more  free  from  fat  than  the  more  superficial.  It 
consists  of  condensed  cellular  substance,  with  very  little  fibrous  matter 
in  it,  and  may  be  considered  as  taking  its  origin  on  the  front  of  the 
thigh,  and  extending  in  front  of  the  abdominal  muscles,  as  high  up  as 
the  thorax :  indeed,  if  we  are  disposed  to  trace  it  in  its  whole  extent, 
there  is  no  difficulty  in  following  it  over  the  front  of  the  thorax  ;  thence 
to  the  neck,  as  the  fascia  superficialis  colli;  and  even  to  the  face.1  In 
ordinary  cases  its  desmoid  or  aponeurotic  character  is  very  equivocal, 
but  where  the  parts  about  the  groin  have  been  pressed  upon  and  thick- 
ened by  the  irritation  of  hernial  protrusion,  it  is  better  marked.  On 
the  thigh  it  is  blended  with  fat ;  and  encloses  between  its  laminae  the 
lymphatic  glands  of  the  groin,  and  the  external  pudic  vessels  given  off 
from  the  femoral  artery,  immediately  below  Poupart's  ligament.  On 
the  tendon  of  the  external  oblique  it  is  more  condensed ;  branches  of 
the  femoral  artery  are  also  seen  in  it  there.  One  longer  and  larger 
than  the  others,  the  Arteria  ad  cutem  abdominis  of  Haller,  winds  over 
Poupart's  ligament,  and  runs  upwards  somewhat  in  the  line  of  the  epi- 
gastric artery,  to  be  distributed  to  the  skin  of  the  abdomen  :  the 

1  This  statement  of  origin  is  to  be  viewed  merely  as  an  anatomical  license  for  descriptive 
purposes;  the  most  natural  line  of  origin  is  the  whole  length  of  the  linea  alba,  and  this  same 
line  might  be  considered  as  going  along  the  front  of  the  sternum  for  the  pectoral  fascia,  and 
along  the  middle  of  the  neck  for  its  fascia  superficialis  and  profunda.  There  is  one  practi- 
cal advantage  in  raising  this  fascia  from  the  side  towards  the  linea  alba,  that  we  see  better 
a  linear  close  adhesion  which  it  makes  with  the  edge  of  Poupart's  ligament,  and  also  how 
the  part  near  the  anterior  superior  spinous  process,  not  forming  such  an  adhesion,  goes  down 
to  the  thigh  and  spreads  itself  over  the  whole  front  of  the  inguinal  portion  of  the  femoral 
fascia.  This  mode  of  raising  exhibits  also,  more  satisfactorily,  the  close  adhesion  of  this 
fascia  to  the  linea  alba  behind  and  to  the  same  line  of  the  skin  before. 


MUSCLES  OF  THE  ABDOMEN.  387 

division  of  it  will  produce  sufficient  hemorrhage  to  require  attention. 
On  the  symphysis  pubis  and  about  the  external  ring  the  laminae  of  the 
fascia  superficialis  are  multiplied,  and  it  has  more  of  the  character  of 
common  adipose  matter,  as  in  most  cases  the  adeps  there  is  abundant 
and  forms  in  both  sexes,  the  protuberance  called  the  Mons  Veneris,  or 
Penil.  From  the  pubes  it  may  be  traced  as  a  condensed  cellular 
membrane,  blended  with  the  ligamentum  suspensorium,  along  the  penis 
to  its  extremity  ;  and,  according  to  Mr.  Colles,  of  Dublin,  matter  formed 
beneath  it  there,  is  apt  to  create  fistulous  sores  on  this  organ.  A  thin 
process  of  this  membrane,  the  Spermatic  or  Inter-columnar  fascia,  adher- 
ing to  the  circumference  of  the  external  abdominal  ring,  may  be  traced 
along  the  spermatic  cord,  and  identified  with  the  tunica  vaginalis  com- 
munis.  The  fascia  abdorninalis  is  more  loosely  connected  to  the  parts 
beneath  it  on  the  thigh,  near  the  anterior  margin  of  Poupart's  ligament, 
than  elsewhere,  which  disposes  femoral  hernia  to  observe  that  course  in 
its  increase.  Along  the  margin  itself  of  Poupart's  ligament,  it  forms 
a  close  adhesion. 

The  Fascia  Superficialis,  under  the  name  of  Tunica  Abdominalis,  is 
well  developed  in  animals  with  a  large  and  projecting  belly,  particu- 
larly in  the  large  ruminantia  and  the  solipedia.  It  has  a  yellowish 
tinge  in  them,  is  very  elastic  and  strong,  and  well  calculated  to  support 
their  viscera.1 

There  are  five  pairs  of  muscles  called  abdominal ;  to  wit,  the  Exter- 
nal Oblique;  the  Internal  Oblique;  the  Transverse  ;  the  Straight;  and 
the  Pyramidal.  The  first  three  are  flat  and  broad,  and  lie  in  layers 
one  upon  the  other ;  the  other  two  are  long. 

1.   The  Obliquus  Externus. 

The  external  oblique  arises  from  the  eight  inferior  ribs  by  muscular 
and  tendinous  digitations  attached  near  their  anterior  extremities. 
The  first  head  is  covered  by  a  slip  from  the  pectoralis  major,  the  five 
upper  heads  are  interlocked  with  the  origins  of  the  serratus  major  anti- 
cus,  and  the  three  inferior  with  those  of  the  latissimus  dorsi.  The 
fibres  pass  obliquely  downwards,  and  terminate  in  a  broad  thin  tendon. 
This  tendon  extends  over  the  whole  front  of  the  abdomen,  from  the 
lower  end  of  the  second  bone  of  the  sternum  to  the  symphysis  of  the 
pubes. 

This  muscle  is  inserted  or  fixed  into  the  whole  length  of  the  linea 
alba ;  into  the  anterior  half  or  two-thirds  of  the  crista  of  the  ilium,  by 
muscular  fibres  posteriorly,  and  tendinous  anteriorly;  and,  from  the 
anterior  superior  spinous  process,  the  tendon  extends  to  the  body  and 
to  the  symphysis  of  the  pubes,  forming  thereby  the  ligament  of 
Poupart,  or  the  Crural  Arch. 

In  the  middle  line  of  the  body,  the  tendons  of  the  three  broad  mus- 
cles, on  both  sides  of  the  abdomen,  unite  to  form  the  Linea  Alba,  which 
extends  from  the  sternum  to  the  pubes.  Many  of  these  fibres  are 

1  Breschet,  Thesis  sur  1'Hernie,  Paris,  1819. 


388  MUSCLES. 

found  crossing  the  linea  alba  and  making  a  thin  transverse  layer  on 
the  tendon  of  the  opposite  side.  From  two  to  three  inches  in  the  adult, 
on  either  side  of  the  linea  alba,  but  more  distant  from  it  above  than 
below,  is  another  line,  formed  by  the  same  tendons,  which  is  the  Linea 
Semi-lunaris.  The  navel,  which  originally  was  a  hole  for  the  passage 
of  the  umbilical  vessels,  and  is  commonly  depressed  into  a  pit,  when 
the  skin  is  on,  appears  in  the  dissection  of  the  linea  alba  as  a  protube- 
rance composed  of  a  condensed  cellular  membrane.  Just  at  the  navel 
there  is  a  line  crossing  the  linea  alba,  and  extending  from  one  linea 
semi-lunaris  to  the  other ;  at  the  lower  end  of  the  Cartilago-Ensiformis, 
there  is  another ;  and  half  way  between  this  and  the  navel,  a  third : 
about  one-third  of  the  way  down  between  the  navel  and  the  pubes,  is  a 
fourth,  but  it  is  generally  imperfect.  These  are  the  Linese  Transversae, 
and  they  are  formed  by  tendinous  matter  in  the  substance  of  the  recti 
muscles,  connecting  them  to  their  tendinous  sheath  in  front. 

The  most  interesting  insertion  of  the  tendon  of  the  external  oblique 
is  the  portion  constituting  Poupart's  ligament,  or  the  Crural  Arch. 
The  latter,  as  it  gets  to  the  pubes  from  the  ilium,  splits  so  as  to  leave  a 
hole  for  the  passage  of  the  Spermatic  Cord  in  the  male,  and  of  the 
Bound  Ligament  of  the  Uterus  in  the  female.  This  opening  is  named 
the  External  Abdominal  Ring.  The  tendon  forming  its  upper  bound- 
ary is  inserted  into  the  symphysis  pubis,  and  into  the  pubes  of  the 
opposite  side,  by  fibres  which  are  interwoven  with  and  decussate  those 
of  its  fellow.  The  tendon  forming  the  lower  margin  of  the  ring  is  in- 
serted into  the  spine  of  the  pubes,  and  into  its  crista  for  an  inch.  The 
portion  inserted  into  the  crista  of  the  pubes  is  Gimbernat's  Ligament, 
which,  it  will  be  readily  understood,  means  only  a  part  of  the  crural 
Arch. 

The  Ring  in  the  External  Oblique  is  rather  triangular  than  round ; 
its  base  is  formed  by  the  body  of  the  pubes,  and  its  point  is  at  the  place 
where  the  tendon  splits.  The  latter  is  kept  from  parting  still  farther 
by  a  fasciculus  of  tendinous  fibres  called  Inter-columnar  tendon,  which 
runs  across  it,  besides  which  from  its  circumference  there  proceeds  the 
adhesion  (fascia  spermatica)  of  the  superficial  abdominal  fascia,  to  the 
spermatic  cord.  The  sides  of  this  opening  are  called  its  Columns,  and 
from  their  situation,  internal  and  external,  or  upper  and  lower  columns. 
In  the  female  it  is  oval  and  scarcely  half  an  inch  long. 

There  are  several  small  round  holes  in  the  tendon  of  this  muscle, 
which  afford  passage  to  nerves  and  to  veins.  When,  by  the  clearness 
of  the  dissection,  the  tendon  has  its  characteristic  gloss  and  polish, 
they  are  very  distinct. 

Use.  This  muscle  compresses  the  viscera  of  the  abdomen  and  brings 
the  pelvis  and  thorax  towards  each  other.1 

1  Varieties.  Sometimes  a  considerable  part  of  its.  middle  and  anterior  portion  is  deficient, 
a  vitiated  conformation,  to  which  it  is  subjected  along  with  the  other  abdominal  muscles. 
The  inferior  part  of  its  tendon  is  incompletely  developed  by  the  absence  of  the  superficial 
fibres  which  retain  together  the  more  deeply  seated,  by  which  it  is  weakened  and  caused  to 
gape  by  one  or  more  large  oblong  fissures :  this  variety  gives  occasion  to  a  form  of  inguinal 
hernia,  differing  materially  from  what  is  common. 

Latterly  the  attention  of  anatomists  has  been  directed  to  a  flat  band  of  cellulo-fibrous 
matter  called  the  Ventrier  or  Belly  Band  ;  which  arises  from  the  tendon  of  the  external  ob- 
Jique,  from  the  linea  alba  to  the  linea  semi-lunaris,  just  above  the  external  abdominal  ring; 


MUSCLES  OF  THE  ABDOMEN. 

Fig.   124. 


389 


A  view  of  the  Superficial  Muscles  of  the  Left  Side  and  of  the  Deep  Muscles  of  the  Right  Side,  on 
the  Front  of  the  Trunk.  1.  Pectoralts  major.  2.  Deltoid.  3.  Anterior  edge  of  latissimus  dorsi. 
4.  Serrated  edge  of  serratus  major  anticus.  5.  Subclavius  muscle.  6.  Pectoralis  minor.  7.  Coraco- 
brachialis.  8.  Biceps  flexor  cubiti  9.  Coracoid  process  of  the  scapula.  10.  Serratus  major  anticus 
after  the  removal  of  the  obliquus  externus  abdominis.  11.  External  intercostal  muscle  of  the  fifth  in- 
tercostal space.  12.  External  oblique  of  the  abdomen.  13.  Its  tendon.  The  median  line  is  the  linea 
alba.-  The  line  to  the  right  of  the  number  is  the  linea  semi-lunaris.  14.  The  portion  of  the  tendon  of 
the  external  oblique,  known  as  Poupart.'s  ligament.  15.  External  abdominal  ring.  16.  Rectus  abdom- 
inis. The  white  spaces  are  the  linea  transversse.  17.  Pyramidalis.  18.  Internal  oblique  of  the  abdo- 
men. 19.  Common  tendon  of  the  internal  oblique  and  transversalis.  20.  Crural  arch.  21.  Fascia 
lata  femoris.  22.'  Saphenous  opening.  The  crescentic  edge  of  the  sartorial  fascia  is  seen  just  above 
Fig.  22,  and  the  interior  or  pubic  point  of  the  crescent  is  known  as  Key's  ligament. 


2.    The  Obliquus  Internus 

Lies  beneath  the  last,  and  its  fibres  pass  in  a  cross  direction  to  the 
fibres  of  the  other.  It  arises  tendinous,  by  the  fascia  lumborum,  from 
the  three  inferior  spinous  processes  of  the  loins  and  from  all  those  of 
the  sacrum  ;  tendinous  and  fleshy,  from  the  whole  length  of  the  crista 
of  the  ilium  ;  and  fleshy,  from  the  upper  or  iliac  half  of  Poupart's 
ligament.  Though  the  fibres  of  this  muscle,  in  general,  decussate  the 
fibres  of  the  external  oblique,  all  of  them  do  not ;  for  the  lower  are 
brought  gradually  to  pursue  the  same  direction  towards  the  symphysis 
of  the  pubes. 

Near  the  Linea  Semi-lunaris,  the  muscular  fibres  cease,  and  the  tendon 
begins. 

It  is  inserted,  by  condensed  fibrous  cellular  membrane,  into  the  car- 

and  passes  downwards  to  be  inserted  into  the  fascia  femoris  over  the  origin  of  the  gracilis. 
Its  outer  margin  reposes  in  front  of  the  spermatic  cord,  and  shoves  it  outwards  as  the  band 
goes  downwards.  Thomson,  Anat.  du  Bas  Ventre.  Paris,  1838. 


390  MUSCLES. 

tilage  of  the  seventh,  eighth,  and  ninth  ribs ;  and  by  flesh  into  the 
tenth,  eleventh,  and  twelfth.  It  is  inserted  also,  membranous,  into 
the  side  of  the  ensiforn  cartilage,  its  whole  length ;  and  into  the  linea 
alba,  from  the  sternum  to  the  pubes. 

The  tendon  of  this  muscle  divides  into  two  laminae,  which  enclose 
the  rectus  muscle,  and  thereby  form  a  sheath  for  it ;  imperfect,  however, 
at  the  lower  posterior  part  near  the  pubes. 

Its  use  is  the  same  as  that  of  the  External  Oblique.1 

3.   The  Transversalis  Abdominis 

Proceeds  directly  across  the  abdomen  and  arises  from  the  transverse 
process  of  the  last  dorsal,  and  of  the  four  upper  lumbar  vertebrae  ;  and 
from  the  back  part  of  the  crista  of  the  ilium,  all,  by  the  Fascia  Lum- 
borum.  It  also  arises,  fleshy,  from  the  anterior  two-thirds  of  the  spine 
or  crista  of  the  ilium,  and  from  the  exterior  half  of  Poupart's  ligament; 
and  tendinous  and  fleshy  alternately,  from  the  inferior  margin  of  the 
thorax,  as  formed  by  the  cartilages  of  the  six  or  seven  inferior  ribs,  at 
their  inner  surfaces,  where  they  are  concerned  in  the  origin  of  the 
diaphragm. 

The  fleshy  part  of  this  muscle  occupies  about  one-third  of  its  extent. 

Fig.  125. 


A  lateral  view  of  the  Muscles  of  the  Trunk,  especially  on  the  Abdomen.  I .  Latissimus  dorsi.  *, 
Serratus  major  anticus.  3.  Upper  portion  of  the  external  oblique.  4.  Two  of  the  external  intercostal 
muscles.  5.  Two  of  the  internal  intercostal  muscles.  6.  Transversalis  abdominis.  7.  Fascia  lum- 
borum.  .  Posterior  part  of  the  sheath  of  the  rectus  or  anterior  aponeurosis  of  the  transversahs 
muscle.  9.  The  rectus  abdominis  cut  off  and  in  its  sheath.  10.  Rectus  abdominis  of  the  right  side. 
11.  Crural  arch.  12.  Gluteus  magnus— medius  and  tensor  vaginae  femoris  covered  by  the  fascia  lata. 

1  Varieties.     It  is  sometimes  defective  at  its  lower  part,  and  on  other  occasions  redundant. 


MUSCLES  OF  THE  ABDOMEN.  391 

It  is  inserted  into  the  side  of  the  ensiform  cartilage ;  filling  up  the 
vacancy  between  it  and  the  cartilage  of  the  sixth  and  the  seventh  ribs; 
and  into  the  linea  alba,  from  the  extremity  of  the  sternum  to  the  pubes. 
The  transversalis  and  the  internal  oblique  also  form  below  a  common 
tendon,  which  is  inserted  for  an  inch  into  the  crista  of  the  pubes,  behind 
the  insertion  of  Gimbernat's  Ligament ;  into  the  spine  of  the  pubes ; 
and  into  that  part  of  the  body  of  the  pubes  which  forms  the  lower  pos- 
terior boundary  of  the  external  abdominal  ring.  Just  above  this  inser- 
tion the  common  tendon  alluded  to,  splits  into  two  laminae,  terminating 
in  the  linea  alba ;  one  of  which  goes  before  and  the  other  behind  the 
pyramidalis  muscle,  so  that  a  sheath  is  thus  formed  for  it.1 
Use ;  to  compress  the  contents  of  the  abdomen.2 

4.   The  Rectus  Abdominis 

Is  seen  beneath  the  tendons  of  the  other  muscles  on  either  side  of  the 
linea  alba.  Its  origin  is  by  a  flat  tendon  of  an  inch  or  more  in  breadth, 
from  the  symphysis  pubis  and  the  upper  posterior  line  of  the  body  of 
the  pubes.  The  muscle  increases  gradually  in  its  ascent,  to  the  breadth 
of  three  inches  or  more.  The  tendinous  intersections,  confining  it  to  the 
tendinous  sheath  in  front,  are  found  at  the  places  mentioned  as  linese 
transversse;  but,  for  the  most  part,  they  do  not  extend  through  the 
muscle.  When  the  origins  of  the  Recti  are  examined  from  behind,  it 
will  be  seen  that  the  internal  edge  of  one  tendon,  just  above  the  sym- 
physis pubis,  overlaps  the  corresponding  part  of  the  other  ;  that  tendi- 
nous filaments  arise  from  the  linea  alba  near  the  pubes,  to  ascend  in 
and  fix  for  an  inch  or  so  its  internal  margin ;  also,  that  a  small  pyra- 
midal ligament  finishes  more  completely  the  structure  just  above  the 
symphysis  pubis;  this  ligament  is  called  by  Breschet,  the  Superior 
Pubic. 

The  rectus  is  inserted  fleshy  into  the  base  of  the  cartilago-ensiformis, 
and  into  the  cartilage  of  the  fifth,  sixth,  and  seventh  ribs. 

It  draws  the  thorax  towards  the  abdomen.3 

5.   The  Pyramidalis 

Is  at  the  lower  front  part  of  the  rectus,  and  is  about  three  inches 
long.  It  arises  somewhat  thick,  tendinous,  and  fleshy,  from  the  upper 
part  of  the  pubes,  from  near  its  spine  to  the  symphysis,  between  the 
rectus  behind,  and  the  insertion  of  the  external  oblique  before.  Being 
fixed  in  the  sheath  formed  by  the  splitting  of  the  tendon  of  the  trans- 
versalis muscle,  it  tapers  to  a  point  above,  and  is  inserted  into  the  linea 

1  The  fascia  iliaca  near  the  anterior  superior  spinous  process  affords  the  surface  devoted  to 
the  origin  of  the  transversalis  abdominis  musole,  instead  of  the  latter  coming,  as  stated   in 
the  general  description,  from  the  crista  of  the  ilium  and  from  the  contiguous  portion  of  Pou- 
part's  Ligament. 

2  Varieties.     Sometimes  transverse  tendinous  fibres  creep  across  its  belly,  and  on  other 
occasions  a  small  transverse  muscle  is  present,  which  decussates  the  larger,  and  is  inserted 
into  the  twelfth  rib. 

8  Varieties.  If  there  be  eight  sternal  ribs,  then  this  muscle  has  an  additional  costal  inser- 
tion. It  sometimes  sends  a  fasciculus  to  the  fourth  rib;  and  I  have  seen  it  ascending  over 
the  pectoralis  major  to  the  root  of  the  neck, as  occurs  in  mammiferous animals. 


892  MUSCLES. 

alba  and  internal  edge  of  the  rectus,  for  about  the  upper  two-thirds  of 
its  own  length. 

It  strengthens  the  lower  part  of  the  abdomen.1 

At  the  linea  semi-lunaris  the  tendon  of  the  internal  oblique  and  that 
Of  the  transversalis  unite  intimately;  arid  just  beyond  this  junction  the 
two  laminae  are  formed,  which  enclose  the  rectus  muscle.  The  anterior 
lamina  is  the  front  layer  of  the  tendon  of  the  internal  oblique,  which, 
after  passing  half  an  inch  or  an  inch,  is  joined  to  the  tendon  of  the  exter- 
nal oblique.  They  then  go  before  the  rectus  muscle,  and  cover  it  from 
origin  to  insertion.  The  posterior  lamina,  made  by  the  posterior  layer 
of  the  tendon  of  the  internal  oblique,  is  united  already  at  the  linea 
aemi-lunaris  to  the  tendon  of  the  transversalis ;  in  this  manner  they 
pass  behind  the  rectus  muscle  from  the  cartilago-ensiformis  to  a  line 
half  way  between  the  umbilicus  and  the  pubes.  From  this  line,  down- 
wards, all  the  tendons  go  in  front  of  the  rectus  muscle. 

The  obliquus  externus  tendon  may  be  dissected  from  the  common 
tendon  of  the  others,  without  much  difficulty,  almost  to  the  linea  alba. 
The  term  insertion  expresses,  very  imperfectly,  the  manner  in  which 
the  tendons  of  these  broad  muscles  all  terminate  in  the  linea  alba  from 
the  thorax  to  the  pelvis.  For  at  the  linea  alba  a  very  intimate  inter- 
texture  of  the  tendons  of  all  these  muscles  occurs,  many  of  the  fibres 
of  the  tendons  escape  from  it  and  are  found  in  front  of  the  tendon  of 
the  external  oblique  of  the  other  side.  Thus  disposed  of,  they  serve 
yery  materially  to  keep  the  fasciculi  of  that  tendon  from  gaping.  A 
strong  example  of  the  arrangement  is  seen  in  the  intercolumnar  tendon 
of  the  external  abdominal  ring.  The  linese  transversse,  by  their  adhe- 
sion in  front  to  the  sheath  of  the  rectus,  have  the  effect  of  a  division  of 
the  latter  into  distinct  muscles,  which  is  readily  seen  in  their  spasmodic 
action  in  tetanus  and  in  some  affections  of  the  abdomen  ;  they  influence 
to  some  extent  also  the  umbilicus  and  linea  alba,  by  being  equivalent  to 
insertions  of  muscle.  For  example,  it  will  be  seen  that  of  the  three 
linese  transversse  above  the  umbilicus,  the  lower  passes  diagonally^  in  a 
zigzag  direction  from  the  umbilicus  upwards  and  outwards ;  the  upper 
one  is  nearly  parallel  with  the  inferior  cartilaginous  margin  of  the 
thorax,  and  the  second  is  nearly  horizontal.  The  fourth  is  not  far  from 
the  horizontal  line,  a  little  below  the  umbilicus. 

The  pyramidales  muscles  are  best  understood  by  their  relation  to  the 
umbilicus.  Acting  upon  the  linea  alba  they  draw  the  umbilicus  down- 
wards, and  thereby  antagonize  the  influence  of  the  upper  lineaa  trans- 
versad.  We  ought  also  to  bear  in  mind  that  the  exterior  margin  of  the 
rectus,  above,  adheres  with  considerable  firmness  to  the  linea  semi- 
lunaris,  and  that  there  is  a  very  close  adhesion  around  the  umbilicus,  to 
the  contiguous  margins  of  the  recti  abdominis.  In  general  spasmodic 
action  of  the  abdominal  muscles,  much  of  the  pain  collects  on  the 
umbilicus;  this  may  be  explained  by  its  being  thus  the  centre  of  many 
radiations  of  muscular  contraction. 

1  Varieties.  It  is  frequently  defective,  but  sometimes  two,  three,  or  even  four,  are  seen 
on  aside.  When  defective, the  rectus  or  obliquus  interims  i*  better  developed  than  usual. 


MUSCLES  OP  THE  ABDOMEN.  393 

The  Cremaster 

Is  a  muscular  sheath  to  the  spermatic  cord,  extending  from  the  ex- 
ternal ring  to  the  testicle,  and  its  origin  is  commonly  attributed  exclu- 
sively to  the  internal  oblique,  as  it  is  said  to  be  a  detachment  of  fibres 
from  it ;  but  it  is  also  formed  by  fibres  from  the  lower  edge  of  the  trans- 
versalis  muscle.  The  history  of  its  origin  is  as  follows:  in  the  descent 
of  the  testicle,  the  latter  has  to  pass  beneath  that  edge  of  the  trans- 
versalis  and  of  the  internal  oblique,  which  is  extended  from  the  iliac 
portion  of  Poupart's  ligament,  to  the  spine  and  the  crista  of  the  pubes. 
As  the  testicle  descends,  it  comes  in  contact  with  a  fasciculus  of  these 
fibres,  and  takes  it  along.  This  constitutes  the  Cremaster  muscle, 
which,  in  adult  life,  and  in  a  strong  muscular  subject,  is  seen  descend- 
ing on  the  outside  of  the  spermatic  cord,  and  spreading  over  the  ante- 
rior part  of  the  tunica  vagirialis  testis  in  arches,  with  their  convexities 
downwards;  then  rising  on  the  inner  side  of  the  cord  to  be  inserted 
into  the  spine  of  the  pubes.1 

It  draws  up  the  testicle. 

The  Fascia  Transversalis  Abdominis. 

The  Fascia  transversalis  is  placed  immediately  behind  the  trans- 
versalis muscle,  between  it  and  the  peritoneum,  and  thus  serves  as  the 
connecting  medium  of  the  two. 

The  view  of  the  fascia  transversalis  from  behind  is  extremely  satis- 
factory. For  a  proper  knowledge  of  this  membrane,  the  profession  is 
indebted  to  the  labors  of  Sir  Astley  Cooper ;  and  much  of  the  zeal 
with  which  the  anatomy  of  hernia  has  been  investigated  is  attributable 
to  him.  The  fascia  transversalis  is  a  thin  tendinous  membrane,  most 
generally  ;  occasionally  it  is  merely  condensed  cellular  membrane.  It 
arises  from  the  internal  or  abdominal  edge  of  Poupart's  ligament,  and 
from  the  crista  of  the  pubes  just  behind  the  insertion  of  the  common 
tendon  of  the  internal  oblique  and  transversalis  muscles,  and  is  ex- 
tended upwards  on  the  posterior  face  of  the  transversalis  muscle  to 
the  thorax.  At  its  origin  it  is  attached  to  the  inferior  edge  of  the  trans- 
versalis and  internal  oblique,  particularly  the  part  between  the  inter- 
nal ring  and  the  symphysis  pubis.  It  is  also  attached  to  the  exterior 
margin  of  the  rectus  abdominis  where  it  is  deprived  behind  of  its 
sheath,  and  it  is  there  continued  to  the  linea  alba,  where  it  runs  into 
its  fellow.  The  internal  abdominal  ring,  or  opening  in  this  fascia, 
marks  it  out  in  some  measure  into  two  portions,  of  which  that  on  the 

1  Jul.  Cloquet,  Anat.  de  I'Homme.  This  account,  though  easily  verified  in  some  sub- 
jects, and  especially  in  such  as  are  muscular,  does  not  appear  to  be  applicable  to  all.  It 
does  not  agree  with  Mr.  John  Hunter's  observation  on  the  descent  of  the  testicle;  for  he 
always  found,  while  the  latter  was  still  in  the  loins,  the  cremaster  running  towards  it. 
Moreover,  in  the  buffalo  of  America,  a  testicle  of  which  the  late  Dr.  R.  Harlan  was  obliging 
enough  to  furnish  me  with  for  dissection,  I  found  that  the  cremaster,  though  remarkably 
robust  and  strong,  forms  none  of  those  nooses  or  arches  with  their  convexities  downwards, 
but  terminates  at  the  testicle  in  a  tendinous  and  somewhat  abrupt  manner.  Taking  all 
these  points  into  consideration,  it  may  be  that  a  part  of  the  cremaster  is  formed  after  the 
manner  indicated  by  Mr.  Hunter,  and  another  part  after  that  mentioned  by  M.  Cloquet  j  or, 
indeed,  cases  may  occur,  presenting  exclusively  one  or  the  other. 


394  MUSCLES. 

iliac  side  of  the  ring  is  not  so  thick  as  the  other,  or  the  one  on  the 
pubic  side ;  and  both  portions  are  much  more  tendinous  near  the 
crural  arch  than  they  are  higher  up. 

Were  it  not  for  the  important  influence  of  the  fascia  superficialis 
abdominis  and  the  fascia  transversalis,  upon  hernia,  and  the  consequent 
necessity  of  a  minute  knowledge  of  them,  their  description  might  be 
much  curtailed  in  considering  them  in  their  proper  light,  to  wit :  as 
sheaths  of  the  abdominal  muscles ;  for  it  is  now  sufficiently  apparent 
that  the  first  is  contiguous  to  the  external  oblique;  and  the  second  to 
the  transverse  muscle,  and  in  this  view  may  be  considered  as  the  sub- 
serous  layer  of  the  peritoneum,  beginning  at  the  pelvis  below,  and  as- 
cending to  the  diaphragm,  and  thus  serving  as  the  connecting  medium. 
Upon  the  same  principle,  fasciae  might  be  made  of  all  the  laminae  of  cel- 
lular substance  intermediate  to  the  abdominal  muscles,  but  it  would  be 
useless.1 

An  opening  through  it,  which  permits  the  spermatic  cord  to  pass,  is 
called  the  Internal  Abdominal  Ring,  in  order  to  distinguish  it  from  the 
opening  in  the  tendon  of  the  external  oblique,  called  the  External 
Ring.  The  internal  ring  is  rather  nearer  to  the  symphysis  pubis  than 
to  the  anterior  superior  spinous  process  of  the  ilium.  The  space  be- 
tween the  internal  ring  arid  the  external  ring  is  about  eighteen  lines 
in  the  adult,  and  is  very  properly  called  the  Abdominal,  Inguinal,  or 
Spermatic  Canal,  from  giving  passage  to  the  Spermatic  cord. 

The  anterior  side  of  the  canal  is  formed  by  the  tendon  of  the  ex- 
ternal oblique;  the  inferior  part,  in  the  erect  posture,  is  formed  by 
Gimbernat's  ligament;  the  posterior  side  is  formed  by  the  fascia  trans- 
versalis; and  above,  this  canal  is  overhung  by  the  internal  oblique  and 
the  transversalis  muscle.  The  spermatic  cord,  after  penetrating  the 
fascia  transversalis,  does  not  cross,  directly  at  right  angles,  the  infe- 
rior edge  of  the  internal  oblique  and  transversalis,  but  it  slips  under 
them  very  obliquely;  its  inclination  being  towards  the  pubes,  so  that 
it  can  be  considered  as  disengaged  from  the  inferior  edge  of  these 
muscles,  only  about  the  middle  of  the  abdominal  canal. 

1  A  very  elaborate  and  exact  account  of  the  construction  of  the  parts  concerned  in  hernia 
has  been  presented  by  Alexander  Thomson,  M.  D.,  under  the  title  of  "Ouvrage  complet  snr 
1'Anatomie  du  Bas  Ventre."  Paris,  1838.  The  character  of  this  work  is  not  so  much  in- 
ventive as  distinguished  by  great  minuteness  of  research,  and  a  different  distribution  of  the 
matter  from  what  is  common,  together  with  a  most  copious  supply  of  new  terms  in  place  of 
old  ones.  Highly  creditable  as  it  is  to  his  industry,  we  can  scarcely  do  less  than  protest 
against  the  latter  irregularity,  and  express  our  apprehensions  that  this  objection,  together 
with  the  unusual  approaches  which  he  has  opened  to  the  structure  as  a  substitute  for 
the  settled  ones,  will  restrict  very  much  the  reception  of  his  work,  and  render  it  less 
acceptable  to  both  teacher  and  student.  The  splitting  and  invention  of  fasciae  were  consi- 
dered for  sometime  as  almost  exclusively  an  Anglican  malady;  but  it  appears,  also,  to  have 
propagated  itself  to  Paris  in  an  exasperated  form,  in  this  production  of  Mr.  Thomson,  and 
in  that  of  M.  Velpeau  (Anatornie  Chirurgicale).  both,  unquestionably,  works  of  much  merit. 
The  practical  anatomist  may  justly  ask,  if  all  of  the  laminae  described  as  such  be  genuine 
fasciae,  what  has  become  of  the  cellular  substance  which  formerly  entered  so  largely  into 
the  composition  of  the  human  body1?  Are  they  not  verbal  novelties  rather  than  new  disco- 
veries? A  sound  anatomical  verdict  is  yet  to  be  given  on  these  points:  our  own  opinion  is, 
that  anatomy  is  too  staid  a  science  for  mere  caprices  in  description  and  names,  arid  that  such 
innovations  cannot  possibly  become  cecurnenical.  The  introduction  of  a  new  name  in  the 
place  of  an  old  one  is  the  highest  act  of  medical  authoriiy,  and  is  so  seldom  sanctioned  by 
general  suffrage,  that  an  individual  inclining  to  it  may  well  pause,  lest,  in  so  doing,  he  may 
seal  up  his  own  publications,  by  the  use  of  terms  too  little  known  to  be  convenient  or  de- 
sirable. 


MUSCLES  OF  THE  ABDOMEN.  395 

The  opening  in  the  Fascia  Transversalis,  or  the  Internal  Ring,  is 
not  abrupt  and  well  defined ;  but  the  fascia,  where  it  transmits  the 
spermatic  cord,  is  reflected  by  a  thin  process,  and  terminates  insensibly 
in  its  cellular  substance ;  this  may  be  considered  as  the  beginning  of 
the  spermatic  fascia.  At  the  posterior  or  ventral  face  of  the  External 
Ring,  the  fascia  transversalis  is  not  in  contact  with  the  cord;  but  that 
part  of  the  tendon  of  the  internal  oblique  and  transversalis  which  is 
inserted  into  the  crista  of  the  pubes,  and  forms  a  sheath  for  the  pyra- 
midalis  muscle,  is  placed  between  them,  and  secures  this  opening. 

The  peritoneum  covering  the  posterior  face  of  the  fascia  transver- 
salis is  thrown  into  a  duplicature  or  falciform  process,  passing  from 
near  the  middle  of  the  crural  arch  towards  the  umbilicus.  This  dupli- 
cature depends  upon  the  round  ligament  of  the  bladder,  which  was  once 
the  umbilical  artery  of  the  foetus.  It  is  broader  near  the  pelvis  than 
it  is  above,  has  its  loose  edge  turned  towards  the  cavity  of  the  abdo- 
men, and  ascends  near  the  pubic  margin  of  the  Internal  Ring.  The 
effect  of  its  existence  is  to  divide  the  posterior  face  of  the  inguinal 
region  into  two  shallow  fossae;  one  next  to  the  ilium,  and  the  other 
next  to  the  pubes.  The  one  next  to  the  ilium  contains  the  beginning 
of  the  internal  abdominal  ring,  which  is  frequently  marked  by  a  little 
pouch  of  peritoneum,  going  along  the  spermatic  cord  for  a  few  lines. 
The  fossa  on  the  inner  or  pubic  side  of  the  falciform  process  is  just 
behind  the  external  ring,  but  separated  from  it  by  the  fascia  transver- 
salis, along  with  the  tendon  of  the  lower  part  of  the  internal  oblique 
and  of  the  transversalis  muscle,  where  it  is  inserted  into  the  pubes, 
and  forms  the  sheath  of  the  pyramidalis.  The  two  fossae  indicate  the 
points  where  inguinal  hernise  commence ;  the  proper  inguinal  protru- 
sion begins  in  the  external  fossa,  and  the  ventro-inguinal  sometimes  in 
the  internal  fossa. 

On  removing  the  peritoneum  from  the  iliacus  internus  muscle,  the 
spermatic  vessels  are  seen  to  descend  from  the  loins  to  the  internal 
ring,  where  they  are  joined  by  the  vas  deferens  coming  from  the 
pelvis.  As  they  engage  under  the  edge  of  the  internal  oblique 
muscle,  after  penetrating  the  ring,  the  cremaster  muscle  is  detached 
to  spread  itself  over  them.  The  spermatic  cord,  thus  constructed, 
passes  through  the  abdominal  canal  in  the  manner  mentioned,  oblique- 
ly downwards  and  inwards ;  and,  emerging  from  the  external  ring,  it 
descends  vertically,  lying  rather  upon  the  outer  column  of  the  ring 
than  upon  its  base. 

On  the  posterior  face  of  the  fascia  transversalis,  between  it  and  the 
peritoneum,  is  the  Epigastric  Artery.  The  epigastric  arises  from  the  ex- 
ternal iliac  as  the  latter  is  about  to  go  under  the  crural  arch  ;  it  ascends 
inwardly  along  the  internal  margin  of  the  internal  abdominal  ring  to 
the  exterior  margin  of  the  rectus  abdominis  muscle,  which  it  reaches 
after  a  course  of  two  and  a-half  or  three  inches.  The  spermatic  cord, 
in  getting  from  the  abdomen  to  the  abdominal  canal,  therefore,  winds, 
in  part,  around  the  epigastric  artery ;  in  the  first  of  its  course  being 
at  the  iliac  edge  of  the  artery,  and  then  in  front  of  it.  Two  epigastric 
veins  attend  the  artery,  one  on  each  of  its  sides,  and  end  by  a  common 
trunk  in  the  external  iliac  vein. 


396  MUSCLES. 

So  much  space  has  been  devoted  to  the  description  of  the  parts  con1 
cerned  in  inguinal  hernia,  that  it  might  be  most  prudent  to  let  it  here 
cease.  A  fair  desire  to  be  accurate  will,  with  some  at  least,  be  an 
apology  for  my  stating,  that  in  practice  it  will  be  found  that  the  iliac 
half  of  Poupart's  ligament  is  bent  down  towards  the  thigh  by  an  adhe- 
sion to  the  iliac  and  to  the  sartorial  fascia  at  their  union ;  that  the 
internal  oblique  and  the  transversalis  muscle,  besides  the  adhesion  to 
Poupart's  ligament  there,  arise,  also,  from  the  iliac  fascia  just  above 
Poupart's  ligament,  from  the  anterior  superior  spinous  process,  almost 
to  the  spermatic  cord  at  the  internal  ring.  The  fascia  transversalis, 
just  above  them,  adheres  in  line  to  the  iliac  fascia,  and  as  it  approaches 
the  femoral  vessels,  is  connected  with  Poupart's  ligament,  but  not 
before  ;  as  it  is  previously  separated  from  the  latter  by  the  whole  thick- 
ness there  of  the  transversalis  and  internal  oblique,  at  their  common 
origin.  The  distance  of  the  inferior  margin  of  the  fascia  transversalis 
from  Poupart's  ligament,  increases  more  and  more  from  the  femoral 
vessels  towards  the  anterior  superior  spinous  process,  being  at  the  latter 
at  least  half  an  inch  ;  and  it  is  also  kept  afterwards,  about  the  same  dis- 
tance from  the  crista  of  the  ilium,  as  it  adheres  there  to  the  circum- 
ference of  the  iliac  fascia.1 

The  anatomical  arrangement  of  the  parts  concerned  in  inguinal 
hernia  in  the  female  is  the  same  as  in  the  male,  except  that  the  round 
ligament  of  the  uterus  supplies  the  place  of  the  spermatic  cord,  and 
there  is  no  cremaster  muscle. 


SECT.  III. — MUSCLES  OF  THE  UPPER  AND  POSTERIOR  PARIETES  OF  THE 

ABDOMEN. 

These  muscles  are  constituted  by  a  single  symmetrical  one,  and  by 
four  pairs:  they  can  only  be  seen  advantageously  by  removing  the 
abdominal  viscera. 

1.   The  Diaphragm  (Diaphragma) 

Is  a  complete,  though  movable  septum,  placed  between  the  thoracic 
and  abdominal  cavities  ;  it  is  extremely  concave  below  and  convex 
above,  the  concavity  being  occupied  by  several  of  the  abdominal 
viscera.  It  is  in  contact  above  with  the  pericardium  and  the  lungs, 
and  below  with  the  liver,  spleen,  and  stomach. 

It  is  connected  with  the  inferior  margin  of  the  thorax,  on  all  sides, 
as  it  exists  in  the  natural  skeleton ;  and  has  for  its  centre  a  silvery  ten- 
don, resembling  in  its  outline  the  heart  of  a  playing  card.  This  cordi- 
form  tendon  occupies  a  considerable  part  of  the  extent  of  the  diaphragm, 
has  its  apex  next  to  the  sternum,  and  its  notch  towards  the  spine;  and 
the  muscular  part  of  the  diaphragm  is  inserted  all  around  into  its  circum- 
ference. The  cordiform  tendon  is  nearly  horizontal  in  the  erect  pos- 
ture, its  elevation  being  on  a  line  with  the  lower  end  of  the  second  bone 

1  For  an  account  of  both  Inguinal  and  Femoral  Hernia,  the  reader  is  referred  to  the  United 
States  Dissector,  or  Lessons  in  Practical  Anatomy,  by  the  present  author.  Revised  edition, 
1846. 


MUSCLES  OF  THE  PARIETES   OF  THE  ABDOMEN.  397 

Fig.  126. 


A  vertical  section  of  the  Front  of  the  Trunk,  showing  its  Posterior  Parietes  and  the  cavities  of 
the  Chest  and  Abdomen. — 1.  Sterno-cl«ido-mastoid.  2.  Longus  colli.  3.  Scalenus  anticus.  4.  Upper 
portion  of  the  serratus  major  anticus.  5.  Intra-costales  muscles  or  appendices  to  the  internal  inter- 
costal muscles.  6.  Internal  intercostal  muscles.  7.  Foramen  quadratum  for  the  inferior  vena  cava. 
8.  Back  part  of  the  cordiform  tendon  of  the  diaphragm.  9.  Middle  of  the  diaphragm,  showing  the 
foramen  cesophageum.  10.  Deltoid.  11.  Insertion  of  the  pectoralis  major.  12.  Biceps  flexor  cubiti. 
13.  Foramen  aorticum  of  the  diaphragm.  14.  Origin  of  the  lesser  muscle  of  the  diaphragm.  15.  Quad- 
ratus  lumborum.  16.  Its  sheath.  17.  Psoas  magnus.  18.  Origin  of  the  psoas  parvus.  19.  Iliacue 
internus.  20,21  Region  of  upper  strait  of  pelvis.  22.  Muscles  of  hip.  23.  Adductor  lougus.  24. 
Pectineus.  25.  Rectus  femoris.  26.  Sartorius. 

of  the  sternum.  On  each  side  of  this  tendon  some  of  the  muscular 
fibres  rise  so  high  upwards  before  they  join  it,  that  they  are  on  a  hori- 
zontal level  with  the  anterior  end  of  the  fourth  rib.  The  fasciculi  of 
muscular  fibres  are,  for  the  most  part,  convergent  from  the  circumfer- 
ence of  the  thorax,  and  are  easily  separated  from  one  another. 

In  the  diaphragm  are  three  remarkable  foramina.  The  first  (the 
foramen  cesophageum)  is  in  the  back  of  the  muscle,  between  the  spine 
and  the  notch  of  the  cordiform  tendon,  a  little  to  the  left  of  the  middle 
line.  It  gives  passage  to  the  oesophagus  and  the  par  vagum  nerves 
along  with  it,  and  is  rather  a  fissure  or  a  long  elliptical  foramen  made 
by  the  separation  and  reunion  of  the  muscular  fibres ;  for,  above  and 
below,  at  each  end  of  the  ellipsis,  these  fibres  decussate  one  another  in 
columns.  To  the  right  of  this  foramen,  and  a  little  above  its  horizon- 
tal level,  in  the  back  part  of  the  cordiform  tendon,  is  a  very  large  and 
patulous  foramen  for  the  ascending  vena  cava  (foramen  quadratum). 


398  MUSCLES. 

Its  form  is  between  an  irregular  quadrilateral  figure  and  a  circle ;  its 
edges  are  composed  of  fasciculi  of  tendon,  rounded  off,  and  are  not  sus- 
ceptible of  displacement,  or  of  alteration  in  their  relative  position  to 
each  other,  by  which  means  any  impediment  to  the  course  of  the  blood 
in  the  ascending  cava,  which  might  arise  from  a  different  arrangement, 
is  obviated.  Almost  in  a  vertical  line  below,  and  about  three  inches 
from  the  foramen  for  the  oesophagus,  is  the  third  hole,  in  the  diaphragm, 
which  affords  passage  to  the  aorta  (hiatus  aorticus).  It  is  just  in 
front  of  the  bodies  of  the  three  upper  lumbar  vertebrae,  and  is  a  much 
longer  elliptical  hole  than  the  oasophageal.  Its  lowest  extremity  or  pole 
is  incomplete,  being  constituted  by  the  tendinous  crura  of  the  dia- 
phragm, and  its  upper,  by  a  decussation  of  muscular  fasciculi  arising 
from  them.  Through  it,  besides  the  aorta,  pass  the  thoracic  duct, 
and  the  great  splanchnic  nerve  of  each  side. 

In  the  horizontal  position  of  either  the  dead  or  the  living  body,  the 
right  side  of  the  diaphragm  ascends  higher  in  the  thorax  than  the  left; 
but  the  weight  of  the  liver  mtikes  it,  in  the  vertical  posture,  descend 
lower  than  the  other. 

Thus  circumstanced,  the  detailed  origin  of  the  Diaphragm  is  as  fol- 
lows: It  arises  fleshy  from  the  internal  face  of  the  upper  end  of  the 
Xiphoid  cartilage ;  from  the  internal  face  of  the  cartilages  of  the 
seventh,  eighth,  and  ninth  ribs;  from  the  osseous  extremities  of  the 
tenth  and  eleventh,  and  from  both  the  osseous  and  cartilaginous  termi- 
nations of  the  twelfth  rib.  As  the  line  described  includes  almost  the 
whole  of  a  circle,  and  the  fibres  all  converge  to  the  cordiform  tendon, 
they,  of  course,  will  pass  in  different  radiated  directions,  and  be  of  dif- 
ferent lengths,  which  it  is  unnecessary  to  specify.  Between  the  ster- 
nal and  costal  portion  on  each  side,  there  is  a  triangular  fissure  filled 
with  fatty  cellular  tissue,  and  which  sometimes  leaves  an  opening  for 
hernia.  I  have  seen  a  case  of  the  kind,  in  which  the  transverse  part 
of  the  colon  was  the  subject  of  protrusion  into  the  thorax.  It  is  proba- 
ble that  the  great  displacement  of  the  abdominal  viscera  into  the  tho- 
rax, which  sometimes  occurs,  may  have  a  congenital  origin  in  this 
fissure,  and  is  subsequently,  when  the  parts  are  accommodated  to  their 
unnatural  situation,  thought  to  be  a  lusus  naturae.  The  portion  just 
described  is  called  the  Greater  Muscle  of  the  Diaphragm. 

Besides  these  origins,  the  diaphragm  has  several  from  the  vertebrae 
of  the  loins,  constituting  its  crura;  there  being  four  on  each  side  of  the 
foramen  for  the  aorta.  The  first  pair,  entirely  tendinous,  comes  from 
the  front  of  the  body  of  the  third  vertebra  of  the  loins,  and  is  prevented 
from  being  very  distinct  in  its  origin,  in  consequence  of  running  into 
the  ligament  in  front  of  the  bodies  of  all  the  vertebrae,  or  the  Anterior 
Vertebral  Ligament  as  it  is  called.  The  second  pair  of  heads  is  on  the 
outside  of  the  first,  and  arises,  tendinous,  from  the  inter-vertebral  liga- 
ment, between  the  second  and  third  vertebrae.  The  third  pair  of  heads 
arises  tendinous  from  the  upper  part  of  the  lateral  face  of  the  second 
lumbar  vertebra.  And  the  fourth  pair  of  heads  comes  also  tendinous, 
from  the  fore  part  of  the  root  of  the  transverse  process  of  the  second 
lumbar  vertebra.  These  tendinous  heads  terminate  in  what  is  called 
the  Lesser  Muscle  of  the  Diaphragm,  which  is  inserted  into  the  notch 
of  the  cordiform  tendon.  It  will  now  be  understood  that  the  aorta 


MUSCLES  OF  THE  PARIETES  OF  THE  ABDOMEN. 

passes  between  the  two  sides  of  the  lesser  muscle,  and  that  the  oesopha- 
gus occupies  a  hole  in  the  upper  part  of  its  belly.1 

The  origin  of  the  diaphragm  is  completed  between  its  greater  and 
lesser  muscle,  by  a  tense  ligament,  the  Ligamentum  Arcuatum,  which 
passes  from  the  root  of  the  transverse  process  of  the  first  lumbar  verte- 
bra to  the  inferior  part  of  the  middle  of  the  twelfth  rib;  with  the  upper 
edge  of  this  ligament  the  diaphragm  is  connected;  and  with  the  lower, 
the  psoas  magnus  muscle,  and  the  quadratus  lumborum.  At  the  mar- 
gin of  the  other  ribs,  the  diaphragm  is  connected  with  the  transversalis 
abdominis. 

Use.  In  consequence  of  the  muscular  fibres  of  the  diaphragm  pass- 
ing in  a  curved  direction  from  the  circumference  of  the  thorax  to  the 
cordiform  tendon ;  and  of  those  fibres  forming  a  sheet,  concave  below 
and  convex  above,  their  contraction  at  the  same  moment  enlarges  the 
cavity  of  the  thorax,  and  has  a  tendency  to  diminish  that  of  the  abdo- 
men, which  latter  is  prevented  by  the  yielding  of  the  abdominal  muscles. 
In  easy  respiration,  its  contractions  and  relaxations  produce  alternately 
the  actions  of  inspiration  and  of  expiration.  Its  descent,  also,  assists 
in  the  expulsion  of  fsecal  and  other  matters  from  the  abdomen.  By  the 
experiments  of  Bourdon,2  it  appears  that  it  only  acts  a  secondary  part 
in  the  latter;  that  its  functions  are  limited  to  inspiration  and  the  asso- 
ciated actions  ;  but  that  in  regard  to  its  power  of  assisting  in  the  expul- 
sion of  the  contents  of  the  abdomen,  all  that  it  does  is  at  first  to 
fill  the  lungs  with  air,  and  then  the  closure  of  the  glottis  prevents  the 
air  from  being  expelled  from  the  lungs.  Common  observation  in  par- 
turition shows  us,  that  the  expulsive  effort  of  the  abdominal  muscles  does 
not  take  place  when  inspiration  is  going  on,  for  the  former  would  prevent 
the  latter ;  but  the  moment  that  expiration  begins,  it  is  arrested  by  the 
firm  closure  of  the  glottis,  and  then  the  abdominal  muscles  contract 
advantageously. 

The  Quadratus  Lumborum 

Is  an  oblong  muscle,  arising  from  the  crista  of  the  ilium,  at  the  side 
of  the  lumbar  vertebrae,  by  a  tendinous  and  fleshy  origin  of  three  inches. 
It  is  inserted  into  the  transverse  process  of  each  of  the  lumbar  vertebrae 
and  of  the  last  of  the  back  by  a  short  tendinous  slip :  it  is  also  inserted 
into  the  lower  edge  of  the  last  rib  near  its  head,  beneath  the  ligament- 
urn  arcuatum. 

It  bends  the  loins  to  one  side,  and  draws  down  the  last  rib. 

It  is  covered  behind  by  the  tendinous  origin  of  the  transversalis 
abdominis,  which  separates  it  from  the  sacro-lumbalis  and  from  the 

1  This  origin  of  tlie  lesser  muscle  of  the  diaphragm  is  given  by  Albinus,  but  it  is  diffi- 
cult to  make  out  fairly ;  for  the  most  part  it  would  be  much  more  correct  to  say  that  it 
arises  tendinous,  from  the  first,  second,  and  third  vertebne  in  front,  and  the  corresponding 
inter-vertebral  matter.  The  heads  are  generally  much  smaller  on  one  side,  the  left,  than 
the  ortier.  From  which  cause  a  large  fasciculus  of  muscle  passes  from  the  right  to  the  left 
side  in  ascending,  and  separates  the  hole  for  the  aorta  from  that  for  the  oesophagus. 
/a  Recherches  sur  la  Respiration  et  la  Circulation,  Paris,  Ib20. 


400  MUSCLES. 

longissimus  dorsi.     It  may  also  be  seen  very  well  from  behind,  in  tho 
dissection  of  the  back.1 


The  Psoas  Parvus 

Arises,  fleshy,  from  the  contiguous  edges  of  the  body  of  the  last  dorsal 
and  of  the  first  lumbar  vertebra  at  their  sides,  and  from  their  inter- ver- 
tebral ligament.  It  is  at  the  anterior  and  internal  edge  of  the  psoas 
magnus ;  has  a  short  belly,  and  a  long  tendon  by  which  it  is  inserted 
into  the  linea  innominata,  about  half  way  between  the  spine  of  the  pubes 
and  the  junction  of  this  bone  with  the  ilium.  The  tendon,  besides,  is 
expanded  into  the  fascia  iliaca. 

Its  use  seems  to  be  to  draw  upwards  the  sheath  of  the  femoral  vessels, 
which  is  derived  from  the  fascia  iliaca,  and,  consequently,  to  draw 
upwards  the  vessels  themselves  ;  which  probably  diminishes  the  liability 
to  injury  from  their  too  great  or  sudden  flexion.  This  muscle  is  some- 
times wanting. 

/ 
The  Psoas  Magnus 

Arises,  fleshy,  from  the  side  of  the  bodies  of  the  last  dorsal  and  of 
the  four  upper  lumbar  vertebrae,  and  from  the  transverse  processes  of 
all  the  lumbar  vertebrae.  It  forms  an  oblong  fleshy  cushion  on  the  side 
of  the  lumbar  vertebrae ;  and,  constituting  the  lateral  boundary  of  the 
inlet  to  the  pelvis,  it  passes  out  of  the  pelvis,  under  Poupart's  liga- 
ment, about  its  middle. 

It  is  inserted,  tendinous,  into  the  back  part  of  the  trochanter  minor 
of  the  os  femoris,  and  fleshy  for  an  inch  below  it. 

It  bends  the  body  forwards,  or  draws  the  thigh  upwards.* 

The  Hiacus  Interims 

Occupies  the  concavity  of  the  ilium,  being  on  the  outside  of  the  psoas 
magnus.  It  arises,  fleshy,  from  the  transverse  process  of  the  last 
lumbar  vertebra;  from  the  internal  margin  of  the  crista  of  the  ilium; 
from  the  whole  concavity  of  the  latter ;  from  its  anterior  edge  at  and 
above  the  anterior  inferior  spinous  process  ;  and  from  that  part  of  the 
capsule  of  the  hip  joint  near  the  latter  process. 

This  muscle  terminates  in  the  tendon  of  the  psoas  magnus,  just 
above  its  insertion  into  the  trochanter  minor. 

This  and  the  psoas  magnus,  from  having  a  common  tendon,  might 
with  propriety  be  considered  as  only  one  muscle.  Their  action  is  the 
same.3 

1  Varieties.     Sometimes  a  broad  tendon  from  it  is  inserted  into  the  inferior  margin  of  the 
body  of  the  eleventh  vertebra  of  the  back.    Sometimes  a  fasciculus  of  it  touches  the  margin 
of  the  eleventh  rib,  near  its  head,  and  above  the  intercostal  vessels. 

2  Varieties.     Sometimes  it  is  joined  by  muscular  fasciculi  from  the  first,  second,  and  even 
third  bone  of  the  sacrum.     Sometimes,  where  it  borders  on  the  pelvis,  there  is  a  small  fas- 
ciculus, which  continues  distinct  almost  to  the  trochanter  minor,  and  then  sends  its  own 
tendon  into  the  common  tendon  of  the  iliacus  internus  and  psoas  magnus. 

3  Varieties.    Sometimes  an  additional  fasciculus  arises  below  the  inferior  anterior  spinous 
process,  and  descends  along  the  external  margin  of  this  muscle.     This  fasciculus  varies 


MUSCLES  OF  THE  BACK.  401 

Of  the  Fascia  Iliaca. 

The  Fascia  Iliaca  is  a  tendinous  membrane,  which  lies  on  the  iliacus 
internus  and  the  psoas  magnus  muscle,  and  is  continued  into  the  tendon 
of  the  psoas  parvus.  Externally,  it  is  connected  to  the  margin  of  the 
crista  of  the  ilium ;  at  the  internal  edge  of  the  psoas  magnus,  it  is 
connected  with  the  brim  of  the  pelvis,  and  sinks  into  the  cavity  of  the 
pelvis,  being  continuous  with  the  aponeurosis  pelvica ;  and  below,  it 
adheres  to  the  edge  of  the  crural  arch,  from  the  anterior  superior 
spinous  process  of  the  ilium  almost  to  the  pubes,  and  is  continued  under 
it  into  the  sartorial  portion  of  the  fascia  femoris.  It  makes  a  line  of 
adhesion  from  the  anterior  superior  spinous  process  to  the  femoral  ves- 
sels, with  the  fascia  transversalis  abdominis.  The  external  iliac  vessels 
are  upon  this  fascia,  between  it  and  the  peritoneum :  and  below  them 
the  fascia  iliaca  goes  over  that  part  of  the  pubes  which  gives  origin  to 
the  pectineus  muscle,  and  is  continuous  with  the  pectineal  fascia,  or  that 
which  covers  the  pectineus  muscle.  By  introducing  the  finger  or  a 
knife  handle  into  a  cut  through  the  fascia  iliaca,  its  attachment  to  the 
crural  arch,  and  its  continuity  with  the  fascia  pectinea  and  sartoria,  will 
be  rendered  very  obvious. 

The  iliac  vessels  pass  beneath  the  crural  arch  on  the  inner  margin  of 
the  psoas  magnus  muscle,  the  vein  being  nearest  the  pubes  and  the 
artery  at  the  outer  side  of  the  vein.  The  fascia  iliaca,  being  blended 
into  the  crural  arch  as  far  as  the  vein,  may  indeed  be  traced  to  the 
crista  of  the  pubes :  it  is  so  connected  with  the  vessels  that  no  opening 
for  hernia  exists  between  them,  or  indeed  in  all  the  space  from  the 
internal  margin  of  the  vein  to  the  spine  of  the  ilium.  But  at  the 
inner  side  of  the  vein,  between  it  and  Gimbernat's  ligament,  an  open- 
ing appears,  called  the  Crural  or  Femoral  Ring,  and  is  the  place  where 
femoral  hernia  commences.  This  opening  is  generally  occupied  by  a 
lymphatic  gland,  and  a  lamina  of  condensed  but  loosely  attached  cel- 
lular substance,  continuous  with  the  aponeurosis  pelvica. 


SECT.  IV. — MUSCLES  ON  THE  POSTERIOR  FACE  OF  THE  TRUNK. 

The  Trapezius,  or  Cucullaris, 

Is  a  beautiful  broad  muscle,  immediately  under  the  skin  ;  it  covers 
the  back  of  the  neck  and  thorax ;  and  extends  from  the  bottom  of  the 
latter  to  the  top  of  the  former.  Its  anterior  edge,  above,  is  parallel 
with  the  posterior  edge  of  the  sterno-cleido-mastoideus.  Its  origin  is 
joined  with  that  of  its  fellow.  Below,  it  overlaps  in  part  the  latia- 
simus  dorsi. 

It  arises  by  a  tendinous  membrane  from  the  posterior  or  external 
occipital  protuberance,  and  from  eight  or  ten  lines,  sometimes  more,  of 
the  superior  semicircular  ridge  of  the  occiput.  It  arises  tendinous  also 

somewhat  in  its  size  at  different  points,  and  is  inserted  into  the  linea  aspera  below  the 
troclianter  minor.  In  very  rare  cases,  the  iliacus  internus  is  kept  totally  distinct  from  the 
psoas  magnus,  from  origin  to  insertion. 

VOL.  i.— 26 


402 


MUSCLES. 


from  the  five  superior  spinous  processes  of  the  neck  through  the  inter- 
vention of  the  ligamentum  nuchae,  and  tendinous  directly  from  the  two 
lower  spinous  processes  of  the  neck,  and  from  all  those  of  the  back. 

It  is  inserted  fleshy  into  the  external  third  of  the  clavicle,  tendinous 
and  fleshy  into  the  inner  edge  of  the  acromion  process,  and  into  all  the 
spine  of  the  scapula.  Its  fibres  having  a  very  extended  origin  must  of 
course  converge  in  getting  to  these  insertions  ;  the  upper  fibres  descend, 
the  lower  ascend,  and  the  middle  are  horizontal.1 

It  draws  the  scapula  towards  the  spine. 

In  the  cervical  portion  of  these  muscles,  formed  by  the  origins  of 

Fig.  127. 


A  view  of  the  Muscles  of  the  Back  as  shown  after  the  removal  of  the  Integuments. — 1.  Occipital 
origin  of  the  trapezius.  2.  Sterno-cleido-mastoideus.  3.  Middle  of  the  trapezius.  4.  Insertion  of 
the  trapezius  into  the  spine  of  the  scapula.  5.  Deltoid.  6.  Second  head  of  the  triceps  extensor  cubiti. 
7.  Its  superior  portion.  8.  Scapular  portion  of  the  latissimus  dorsi.  9.  Axillary  border  of  the  pec- 
toralis  major.  10.  Axillary  border  of  the  pectoralis  minor.  11.  Serratus  major  anticus.  12.  Infra- 
spinntus.  13.  Teres  minor.  14.  Teres  major.  15.  Middle  of  the  latissimus  dorsi.  16.  Externnl 
oblique  of  the  abdomen.  17.  Gluteus  medius.  18.  Fascia  of  ditto.  19  Gluteus  magnus.  20.  Fascia 
lumborum. 

1  Varieties.  It  is  sometimes  short  of  the  origin  described,  by  from  one  to  four,  of  the 
lower  spinous  processes  of  the  back.  Also  the  lower  fasciculus  is  sometimes  disjoined  from 
the  rest  of  the  muscle,  by  a  large  triangular  space. 


MUSCLES  OF  THE  BACK.  403 

both  united,  is  an  elliptical  expanse  of  tendon,  lying  over  the  liga- 
mentum  nuchae,  and  extended  on  each  side.  The  ligamentum  nuclue 
itself,  as  mentioned  elsewhere,  is  a  vertical  septum  of  ligamentous  mat- 
ter, extending  from  the  central  line  of  the  occipital  bone  (crista  occi- 
pitalis)  to  the  spinous  processes  of  all  the  vertebrae  of  the  neck.  At 
its  upper  part,  where  the  spinous  processes  of  the  neck  are  short,  this 
septum  is  very  broad,  and  divides  completely  the  muscles  of  the  two 
sides  of  the  neck. 

The  Latissimus  Dorsi 

Is  situated  under  the  skin  at  the  lower  part  of  the  back,  so  as  to 
cover  the  whole  posterior  portion  of  the  latter.  It  arises  by  a  thin  ten- 
dinous membrane,  from  the  seven  inferior  spinous  processes  of  the 
back ;  and  by  a  thick  tendinous  membrane  from  all  those  of  the  loins 
and  sacrum.  Its  origin  also  extends  in  this  condition  along  the  outer 
inferior  margin  of  the  sacrum,  and  from  the  posterior  third  of  the  spine 
of  the  ilium.1  Besides  which,  the  latissimus  dorsi  has  from  the  sides 
of  the  three  or  four  inferior  false  ribs,  as  many  fleshy  heads  which  are 
connected  with  the  inferior  heads  of  the  obliquus  externus  abdominis. 

From  this  extended  origin  the  fibres  converge,  so  as  to  form  the  pos- 
terior fold  of  the  axilla,  and  to  terminate  in  a  flat,  thick  tendon,  of 
two  inches  in  breadth,  which  is  inserted  into  the  lower  part  of  the  pos- 
terior ridge  of  the  bicipital  groove  of  the  os  humeri.  The  upper  part 
of  this  muscle  passes  over  the  inferior  angle  of  the  scapula,  and  derives 
a  fasciculus  of  fibres  from  it.  It  is  there  behind  the  teres  major,  but 
as  it  advances  it  winds  around  the  inferior  edge  of  the  latter  so  as  to 
get  before  it.  Afterwards  the  tendons  of  the  two  adhere  closely,  but 
have  a  bursa  between  them  at  their  termination.  That  portion  of  the 
tendon  of  the  latissimus  which  is  continuous  with  the  lower  edge  of  its 
fleshy  belly,  becomes  uppermost  by  a  half  spiral  turn  in  the  latter ; 
while  the  upper  portion  is  by  the  same  arrangement  made  lowest.  At 
the  place  of  its  insertion,  it  is  commonly  connected  to  the  pectoralis 
major,  by  an  adhesion  crossing  the  bicipital  groove,  at  its  bottom.  The 
inferior  margin  of  its  tendon  detaches  a  slip  to  the  brachial  fascia,  and 
the  superior  margin  another  to  the  smaller  tuberosity  of  the  os  humeri. 

It  draws  the  os  humeri  downwards  and  backwards.2 

That  portion  of  its  origin,  being  the  tendinous  membrane  coming  from 
the  spinous  processes  of  the  loins,  is  the  fascia  lumborum,  and  is  com- 
mon to  the  latissimus,  the  internal  oblique  and  the  transverse  muscle  of 
the  abdomen,  and  several  other  muscles  to  be  mentioned. 

The  origin  of  the  two  latissimi  muscles  conjointly  makes  a  beautiful 
lozenge-shape  expansion  of  tendon,  occupying  its  entire  spinal  region, 
the  longest  diameter  is  vertical  and  just  over  the  spinous  processes,  the 
lateral  diameter  extends  from  one  crista  of  the  ilium  to  the  other. 

1  This  origin  frequently  is  tendinous  at  the  back  part  of  the  ilium,  and  fleshy  in  front. 

2  Varieties.    Sometimes  from  its  anterior  extremity  a  fleshy  or  tendinous  slip  is  detached 
in  front  of  the  coraco-brachialis,  and  is  inserted  into  the  posterior  face  of  the  tendon  o(   the 
pectoralis  major.     The  brachial  vessels  and  nerves  are  liable  to  compression   from  this  ar- 
rangement, which  is  said  to  be  natural  to  birds  and  moles.    Another  variety  is  where  a  slip 
runs  from  this  muscle,  adheres  to  the  coraco  brachialis,  and  is  inserted  tendinous  into  the 
coracoid  process  of  the  scapula. 


404  MUSCLES. 

The  Serratus  Inferior  Posticus. 

The  origin  of  this  muscle  is  inseparably  united  to  that  of  the  latis- 
simus  dorsi  by  the  fascia  lumborum,  and  comes  from  the  two  inferior 
spinous  processes  of  the  back,  and  the  three  superior  of  the  loins. 

It  is  inserted  by  fleshy  digitations  into  the  under  edge  of  the  four 
inferior  ribs. 

It  draws  the  ribs  downwards,  and  is  an  antagonist  to  the  diaphragm 
in  some  respects,  but  more  particularly  to  the  serratus  superior  posticus. 

The  removal  of  the  trapezius  brings  into  view  several  muscles :  the 
most  superficial  of  which  are  the  rhomboid,  which,  being  two  together, 
look  very  much  like  one. 

The  Rhomboideus  Minor 

Is  above  the  other.  It  is  a  narrow  muscle,  which  arises  by  a  thin 
tendon  from  the  three  inferior  spinous  processes  of  the  neck,  and,  pass- 
ing obliquely  downwards,  is  inserted  into  the  base  of  the  scapula,  oppo- 
site the  beginning  of  its  spine. 

The  Rhomboideus  Major 

Arises,  also,  by  a  thin  tendon  from  the  last  spinous  process  of  the 
neck,  and  from  the  four  superior  of  the  back,  and  is  inserted  into  all 
the  base  of  the  scapula  below  its  spine. 

These  muscles  draw  the  scapula  upwards  and  backwards. 

The  Levator  Scapulse 

Is  placed  between  the  posterior  edge  of  the  sterno-cleido-mastoideus 
and  the  anterior  of  the  trapezius;  its  lower  end  is  just  above  therhom- 
boideus  minor.  It  arises  by  rounded  tendons  from  the  three,  four,  or 
five  superior  transverse  processes  of  the  neck,  between  the  scaleni  mus- 
cles and  the  splenius  colli. 

It  is  inserted,  fleshy,  into  that  part  of  the  base  of  the  scapula  above 
the  origin  of  its  spine.  As  its  name  expresses,  it  draws  the  scapula 
upwards.  A  good  view  of  this  muscle  may  be  obtained  in  the  front 
dissection  of  the  neck.1 

The  Serratus  Superior  Posticus 

Arises  by  a  thin  tendon  from  the  three  inferior  spinous  processes  of 
the  neck,  and  the  two  superior  of  the  back,  and  is  inserted  into  the 
second,  third,  fourth,  and  fifth  ribs,  by  tendinous  and  fleshy  slips,  a 
little  beyond  their  angles. 

This  muscle  draws  the  ribs  upwards. 

*  Varieties.  Sometimes  it  arises  from  only  two  superior  transverse  processes ;  occasionally 
its  fasciculi  are  separated  from  the  neck  to  the  scapula;  or  a  long  one  is  detached  towards 
the  spine,  thereby  presenting  a  disposition  similar  to  what  is  met  with  in  the  dolphin. 


MUSCLES  OF  THE  BACK.  405 

From  the  Serratus  Superior  to  the  Inferior,  is  an  aponeurotic  expan- 
sion described  by  Rosenmuller.  which  connects  them  together,  and  has 
induced  some  anatomists  to  consider  them  as  but  one  muscle.  It  is  thin 
and  diaphanous;  but  has  the  fibrous  structure  very  apparent,  and  run- 
ning in  a  transverse  direction  from  the  spinous  processes  to  the  angles 
of  the  ribs.  The  superior  margin  of  the  latissimus  dorsi  also  runs  into 
this  fascia,  so  as  to  render  its  own  bounds  somewhat  undefined.  This 
fascia,  along  with  the  ribs  and  vertebrae,  forms  that  gutter  in  which  are 
contained  the  deep-seated  muscles  of  the  back. 

The  Splenius 

Has  its  inferior  extremity  beneath  the  serratus  superior  posticus,  but 
the  principal  part  of  it  is  covered  by  the  trapezius.  It  arises  from  the 
spinous  processes  of  the  five  inferior  cervical,1  and  of  the  four  superior 
dorsal  vertebrae. 

It  is  inserted  into  the  back  of  the  mastoid  process  and  continuous 
ridge  of  bone,  extending  upon  a  small  part  of  the  adjacent  portion  of 
the  os  occipitis,  also  into  the  transverse  processes  of  the  two  superior 
cervical  vertebrae.  It  is  customary  to  consider2  the  part  which  goes  to 
the  head  as  Splenius  Capitis,  and  the  part  below  as  Splenius  Colli:  the 
latter,  in  that  case,  is  said  to  arise  from  the  third  and  fourth  dorsal  ver- 
tebrae. It  draws  the  head  and  neck  backwards. 

Between  the  spinous  processes  of  the  vertebrae  and  the  angles  of  the 
ribs,  on  either  side,  the  deep  fossa  is  filled  up  entirely  by  muscles. 
Some  of  them  are  large  and  powerful,  and  the  most  striking  are  the 
Sacro-Lumbalis  and  the  Longissimus  Dorsi. 

The  Sacro-Lumbalis  and  Longissimus  Dorsi 

Have  a  common  origin  from  the  back  of  the  pelvis  and  of  the  lumbar 
vertebrae,  and  extend  to  the  top  of  the  thorax.  They  thus  arise  tendi- 
nous posteriorly,  and  fleshy  anteriorly,  from  the  posterior  surface  of 
the  sacrum  by  its  external  margin  and  spinous  processes:  they  arise, 
also,  tendinous,  from  the  spinous  processes,  and  fleshy,  from  the  ends 
of  the  transverse  processes  of  all  the  vertebrae  of  the  loins ;  and  prin- 
cipally tendinous  from  the  posterior  part  of  the  spine  of  the  ilium.  The 
external  margin  of  the  belly  is  fleshy;  and  all  the  part  nearest  to  the 
spine  is  wholly  tendinous  below,  but,  higher  up  in  the  loins,  it  is  so  only 
on  the  surface.  The  tendon  is  very  strong,  and  divided  into  fasciculi, 
chiefly  near  the  spinous  processes  of  the  lumbar  vertebrae.  From  the 
under  surface  of  this  common  belly,  two  heads,  tendinous  and  fleshy, 
are  inserted  into  the  inferior  edge  of  the  transverse  process  of  each 
lumbar  vertebra,  the  smaller  near  its  root,  and  the  larger  near  its 
extremity.  On  a  level  with  the  lower  rib,  and,  indeed,  somewhat  below 
it,  a  fissure  occurs  in  the  muscle  which  divides  it  into  its  two  parts. 

1  In  the  cnse  of  anyone  of  the  five  superior  spinous  processes  of  the  neck,  it  is'to  be  under- 
stood that  the  li-jaineutum  midut-is  the  medium  of  origin  in  this  as  in  other  muscles. 

2  Albums,  loc.  cit. 


406  MUSCLES. 

The  Longissimus  Dorsi  is  nearest  the  spine;  it  is  inserted,  by  small 
double  tendons,  proceeding  from  its  internal  surface,  into  the  ends  of 
the  transverse  processes  of  all  the  vertebrae  of  the  back,  except  the 
first.  It  also  from  its  outer  edge  sends  long  slender  tendons,  by  which 
it  is  inserted  into  the  under  edges  of  all  the  ribs,  beyond  their  tubercles, 
except  the  two  inferior. 

The  Sacro-Lumbalis  is  inserted  from  its  outer  edge  into  all  the  ribs 
at  their  angles,  by  long  and  thin  tendons,  which  are  successively  longer, 
the  higher  they  are  inserted. 

By  turning  over  this  muscle  towards  the  ribs,  from  the  other,  one 
may  see  coming  from  the  eight  lower  ribs  as  many  slips,  which  run 
into  the  under  surface  of  the  sacro-lumbalis :  they  are  the  Musculi 
Accessorii  ad  Sacro-Lumbalem. 

These  two  muscles  keep  the  spine  erect,  and  draw  down  the  ribs.1 

The  Spinalis  Dor  si, 

Between  the  ends  of  the  spinous  processes  and  the  edge  of  the  lon- 
gissimus  dorsi,  is  a  muscle  almost  entirely  tendinous,  and  scarcely  to 
be  distinguished  from  the  latter,  both  in  consequence  of  its  close  con- 
nection with  it,  and  of  its  insignificant  size.  At  its  lower  part,  it  is 
absolutely  a  portion  of  the  longissimus,  and  can  be  separated  from  it 
only  by  a  forced  division.  It  is  a  mere  string  lying  along  the  sides  of 
the  spinous  processes,  and  is  called,  from  its  origin  and  insertion,  the 
Spinalis  Dorsi. 

It  arises  tendinous  from  the  spinous  processes  of  the  two  superior 
lumbar,  and  of  the  three  inferior  dorsal  vertebrae,  and  is  inserted, 
tendinous,  into  the  spinous  processes  of  the  nine  superior  dorsal  verte- 
brae, except  the  first. 

It  tends  to  keep  the  spine  erect.2  • 

The  Oervicalis  Descendens 

Is  a  small  muscle  placed  at  the  upper  portion  of  the  thorax,  between 
the  insertions  of  the  sacro-lumbalis,  and  of  the  longissimus  dorsi  into 
the  upper  ribs ;  it  looks  at  first  very  much  like  a  continuation  or  ap- 
pendix of  the  first,  running  to  the  cervical  vertebrae. 

This  muscle  arises  from  the  upper  edges  of 'the  four  superior  ribs  by 
long  tendons;  it  forms  a  small  belly  which  is  inserted  by  three  distinct 
tendons  respectively  into  the  transverse  process  of  the  fourth,  fifth, 
and  sixth  vertebrae  of  the  neck,  between  the  levator  scapulae  and  sple- 
nius  colli. 

It  draws  the  neck  backwards. 

1  Varieties.     The  origin  is  uniform,  but  the  insertions  vary  in  their  number.     Sometimes, 
a  fasciculus  commences  by  a  tendinous  beginning  from  the  fourth   rib,  and  is  inserted  into 
the  transverse  process  of  the  sixth  vertebra  of  the  neck;  a  fasciculus  from  the  sacro-Jumbalis 
joins  the  fascia  extended  between  the  two  serrati,  or  reaches  to  the  splenius  colli:  the  two 
muscles  are  sometimes  joined  closely  by  an  intermediate  fasciculus. 

2  This  muscle,  together  with  the  sacro-lumbalis  and  the  longissimus  dorsi 'are  spoken  of 
collectively  as  the  Erector  Spinae. 


MUSCLES  OF  THE  BACK.  407 

The  Tramversalis  Cervicis 

Is  on  the  inner  side  of  the  last,  and  in  contact  with  it,  being  about 
the  same  size,  and  having  very  much  the  same  course  and  appearance. 
It  is  considered  as  an  appendage  to  the  longissirnus  dorsi. 

It  arises  from  the  transverse  processes  of  the  five  superior  dorsal 
vertebrae  by  distinct  tendons,  and  forms  a  narrow  fleshy  belly, "which 
is  inserted  by  distinct  tendons,  also,  into  the  transverse  processes  of  the 
five  middle  cervical  vertebrae. 

It  draws  the  head  backwards. 

The  Trachelo-Mastoideus 

Is  at  the  inner  side  of  the  last  muscle,  in  contact  with  it. 

It  arises  by  distinct  tendinous  heads,  from  the  transverse  processes 
of  the  three  superior  vertebrae  of  the  back,  and  of  the  five  inferior  of 
the  neck ;  and  is  inserted,  by  a  thin  tendon,  into  the  posterior  edge  of 
the  mastoid  process  immediately  within  the  insertion  of  the  splenius 
capitis. 

The  dorsal  origins  are  frequent,  deficient,  or  irregular. 

It  draws  the  head  backwards. 

The  Complexus, 

A  fine  large  muscle,  is  situated  at  the  inner  face  of  the  trachelo- 
mastoideus,  and  is  readily  recognized,  by  showing  itself  between  the 
bellies  of  the  two  splenii  capitis,  just  below  the  occiput.  A  quantity 
of  tendinous  matter  exists  in  its  middle,  which  gives  it  the  complicated 
appearance  from  whence  its  name  is  derived. 

It  arises,  by  tendinous  heads,  from  the  seven  superior  dorsal,  and 
the  four  inferior  cervical  vertebrae,  by  their  transverse  processes ;  also, 
by  a  fleshy  slip  from  the  spinous  process  of  the  first  dorsal.  It  is 
inserted  into  the  inferior  part  of  the  os  occipitis,  by  the  surface  between 
the  upper  and  lower  semicircular  ridges,  on  the  outside  of  the  vertical 
ridge  (crista  occipitalis)  which  exists  in  the  middle  of  the  bone. 

It  draws  the  head  backwards. 

.    The  Semi-spinalis  Cervicis 

Is  a  muscle  which  passes  obliquely  from  transverse  to  spinous  pro- 
cesses, and  is  situated  between  the  complexus  and  the  multifidus  spinae; 
the  course  of  its  fibres  renders  it  difficult  to  be  distinguished  from  the 
latter. 

It  arises  from  the  transverse  processes  of  the  six  upper  vertebrae  of 
the  back,  by  tendons  which  adhere  to  those  of  the  adjacent  muscles ; 
and  passes  up  to  the  neck,  to  be  inserted  into  the  sides  of  the  spinous 
processes  of  the  five  middle  cervical  vertebras. 

It  extends  the  neck  obliquely  backwards. 


408  MUSCLES. 

The  Semi-spinalis  Dorsi 

Is  lower  down  on  the  spine,  and  with  difficulty  distinguished  from 
the  multifidus ;  like  the  last,  it  passes  from  transverse  to  spinous  pro- 
cesses. It  lies  under  the  longissimus  dorsi,  between  it  and  the  multi- 
fidus. 

This  muscle  arises  by  tendons  connected  with  those  of  the  other 
muscles,  from  the  transverse  process  of  the  seventh,  eighth,  ninth,  and 
tenth  dorsal  vertebra ;  and  passes  upwards  obliquely,  to  be  inserted, 
tendinous,  into  the  sides  of  the  spinous  processes  of  the  two  lower  cer- 
vical, and  of  the  five  upper  dorsal  vertebrae. 

It  draws  the  spine  obliquely  backwards. 

The  Multifidus  Spinse 

Lies  under  the  muscles  as  yet  mentioned,  close  to  the  bones  of  the 
spine  ;  in  order  to  see  it  well,  they,  therefore,  should  all  be  cut  away. 

It  has  its  commencement,  tendinous  and  fleshy,  on  the  back  of  the 
sacrum,  being  connected  to  its  spinous  processes  and  posterior  surface, 
also  to  the  back  part  of  the  spine  of  the  ilium.  It  there  forms  a  belly 
of  sufficient  magnitude  to  fill  up  much  of  the  cavity  between  the  spinous 
processes  of  the  sacrum  and  the  posterior  part  of  the  ilium.  It  arises 
also  from  the  roots  of  the  oblique  and  transverse  processes  of  all  the 
vertebrae  of  the  loins,  of  the  back,  and  of  the  four  inferior  of  the  neck. 

The  multifidus  is  inserted,  tendinous  and  fleshy,  into  the  roots  and 
sides  of  the  spinous  processes  of  all  the  vertebrae  of  the  loins,  of  the 
back,  and  of  the  five  inferior  of  the  neck. 

This  muscle  consists  of  a  great  number  of  small  bellies,  which  are 
parallel  to  each  other,  and  each  of  which  arises  from  a  transverse  or 
oblique  process,  and  goes  obliquely  to  the  spinous  process  either  of  the 
first  or  second  vertebra  above  it. 

It  twists  the  spine  backwards,  and  keeps  it  erect. 

Between  the  head  and  the  first  and  second  vertebrae,  and  between  the 
latter  two,  there  are  on  either  side,  four  small  muscles,  intended  for  the 
motion  of  these  parts  upon  each  other.  They  are  brought  into  view  by 
the  removal  of  the  complexus. 

The  Rectus  Capitis  Posticus  Major 

Arises,  tendinous  and  fleshy,  from  the  extremity  of  the  spinous  process 
of  the  vertebra  dentata,  and  is  inserted  into  the  inferior  transverse  or 
semicircular  ridge  of  the  os  occipitis,  and  into  a  part  of  the  continuous 
surface  of  bone  just  below  it. 

Its  shape  is  pyramidal,  the  apex  being  below.  It  turns  the  head, 
and  also  draws  it  backwards. 

The  Rectus  Capitis  Posticus  Minor 

Is  at  the  internal  edge  of  the  first.  It  arises,  tendinous,  from  the 
tubercle  on  the  back  part  of  the  first  vertebra,  and  is  inserted  into  the 


MUSCLES  OF  THE  BACK.  409 

internal  end  of  the  inferior  transverse  or  semicircular  ridge  of  the  os 
occipitis,  and  into  a  part  of  the  surface  between  it  and  the  foramen 
magnum. 

It  is  also  pyramidal,  with  the  apex  downwards.  It  draws  the  head 
backwards. 

TJie  Obliquus  Capitis  Superior 

Arises  from  the  transverse  process  of  the  first  cervical  vertebra,  and 
is  inserted  into  the  outer  end  of  the  inferior  semicircular  ridge  of  the 
os  occipitis,  behind  the  posterior  part  of  the  mastoid  process,  and  be- 
neath the  splenius  muscle. 

It  draws  the  head  backwards. 

The  Obliquus  Capitis  Inferior 

Arises  from  the  side  of  the  spinous  process  of  the  vertebra  dentata, 
and  is  inserted  into  the  back  part  of  the  transverse  process  of  the  first 
vertebra  of  the  neck. 

It  rotates  the  first  vertebra  on  the  second. 

The  Inter- Spinales 

Are  small  short  muscles,  placed  between  the  spinous  processes  of  con- 
tiguous vertebrae.  In^the  neck  they  are  double,  in  consequence  of  the 
spinous  processes  there  being  bifurcated ;  in  the  back  they  are  almost 
entirely  tendinous;  in  the  loins  they  are  single  and  well  marked. 

They  draw  the  spinous  processes  together,  and  keep  the  spine  erect. 

The  Inter-  Transversarii 

Are  also  short  muscles,  placed  in  a  similar  manner  between  the 
transverse  processes  of  the  vertebrae.  In  the  neck  they  are  double;  in 
the  back  they  are  small,  tendinous,  and  not  well  marked ;  and  in  the 
loins  they  are  single  and  well  seen. 

They  draw  the  transverse  processes  together,  and  will,  of  course, 
bend  the  spine  to  one  side. 

The  Levatores  Oostarum 

Are  small  muscles  concealed  by  the  sacro-lumbalis  and  longissimus 
dorsi,  and  pass  from  the  transverse  processes  of  the  last  cervical  and 
of  the  eleven  superior  dorsal  vertebrae,  to  the  upper  edges  of  the  next 
ribs.  They  are  twelve  on  either  side  of  the  spine,  are  tendinous  in  their 
origins  and  insertions,  with  intermediate  muscular  bellies. 

The  upper  ones  are  small  and  thin.  They  increase  in  magnitude  as 
they  descend.  From  the  inferior  edge  of  nearly  all  these  muscles,  a 
fleshy  slip  is  detached,  which  passes  over  the  rib  next  below  its  origin, 
to  the  second  rib  below,  and  occasionally  to  the  third.  These  slips  are 
called  Levatores  Costarum  Longiores.  The  others  which  descend  from 


410  MUSCLES. 

the  transverse  process  to  the  rib  next  below  are  called  Levatores  Cos- 
tarum  Breviores. 

These  muscles  are  parallel  in  their  obliquity,  with  the  external  inter- 
costals,  and  are  not  very  obviously  separated  from  them.  They  per- 
form the  same  service,  that  of  elevating  the  ribs. 

The  Rotatores  Dorsi  of  Professor  Theile,  of  Bern,  pass  from  the 
transverse  process  of  a  vertebra  below,  to  the  under  margin  of  the  arch 
of  the  vertebra  above.  They  are  eleven  in  number  on  each  side,  be- 
ginning at  the  second  dorsal  vertebra,  and  ending  at  the  twelfth.  It 
may  be  considered  as  questionable  whether  any  advantage  will  arise  to 
descriptive  anatomy  by  thus  separating  from  the  Multifidus  Spinse,  fas- 
ciculi heretofore  considered  a  part  of  it,  but  which  Professor  Theile 
says  are  marked  off  by  a  layer  of  cellular  tissue.  As  much  may  be  said 
at  least  of  all  the  numerous  strips  making  up  the  multifidus  spinae. 


CHAPTER  III. 

OF  THE  FASCLE  AND  MUSCLES  OF  THE  UPPER  EXTREMITIES. 
SECT.  I. — FASCIA. 

THE  muscles  of  each  upper  extremity  are  invested  by  an  aponeurotic 
membrane  called  the  Brachial  Fascia,  which  extends  from  the  shoulder 
to  the  hand.  It  might  be  very  properly  divided  into  the  Humeral 
fascia,  or  that  surrounding  the  shoulder ;  the  Brachial,  or  that  around 
the  arm ;  the  Antebrachial  or  that  around  the  fore  arm,  and  the 
Fascia  of  the  Hand  (fascia  manus).  It  begins  at  the  base  and  spine 
of  the  scapula,  the  margin  of  the  acromion  process,  the  acromial  ex- 
tremity of  the  clavicle,  and  from  the  cellular  membrane  in  the  arm-pit, 
and  extends  itself  over  all  the  muscles  of  the  dorsum  of  the  scapula, 
and  over  the  deltoid  muscle.  A  division  of  it  is  found  covering  the 
supra-spinatus  muscle,  being  of  a  well-marked  ligamentous  character, 
and  extended  from  the  margins  of  the  fossa  supra-spinata.  The  ten- 
dons of  the  latissimus  dorsi  and  pectoralis  major  each  send  off  from 
their  margins  an  expansion  which  is  lost  in  it.  Below  the  spine  of  the 
scapula  it  is  strong  and  well  marked,  but  on  the  deltoid  muscle,  as  well 
as  on  the  muscles  of  the  arm,  its  desmoid  character  is  by  no  means  so 
well  developed,  though  it  still  retains  the  appearance  of  a  distinct 
membrane,  and  can  be  raised  up  as  such  from  the  muscles.  On  the 
fore  arm  its  ligamentous  appearance  is  well  preserved,  and  extends 
from  the  elbow  to  the  wrist  inclusively.  Its  longitudinal  fibres  there 
are  well  secured  by  transverse  ones. 

Above  the  condyles  of  the  os  humeri,  the  Fascia  Brachialis  sends 
down  to  the  bone  a  strong  tendinous  partition  to  each  ridge,  and  which 
runs  the  length  of  the  latter  from  its  upper  end  to  the  condyle.  These 


FASCIA.  411 


processes  separate  the  muscles  on  the  back  of  the  arm  from  such  as 
are  on  the  front  of  it,  and  are  sometimes  called  the  Ligamentum 
inter-nmsculare  internum  and  externum.  They  afford  origin  to  many 


Fig.  128. 


An  anterior  view  of  the  Fascia  Brachialis.  1.  Portion  covering  the  deltoid  muscle.  2.  Por- 
tion covering  the  upper  part  of  the  biceps.  3.  Portion  covering  the  coraco-brachialis.  4.  Portion 
covering  the  lower  part  of  the  biceps.  5.  Tendon  of  the  biceps.  6.  Opening  for  the  vein.  7.  Apo- 
neurosis  as  strengthened  by  the  expansion  from  the  tendon  of  the  biceps.  8.  Fascia  over  the  flexor 
sublimis.  9.  Fascia  over  the  flexor  carpi  radialis.  10.  Commencement  of  the  palmar  fasciu. 

muscular  fibres.  At  the  bend  of  the  elbow,  the  fascia  brachialis  is 
joined  by  a  fasciculus  of  tendinous  matter  from  the  ulnar  margin  of 
the  tendon  of  the  biceps  flexor  cubiti,  and  which,  in  the  contraction  of 
the  muscle,  will  keep  the  fascia  tense. 

At  the  lower  extremity  of  the  fore  arm,  the  transverse  fibres  of  the 
ante-brachial  fascia,  after  diminishing  sensibly,  become  more  numerous, 
and  by  their  attachments  to  the  several  ridges  on  the  back  of  the 
radius  and  of  the  ulna,  form  the  Ligamentum  Carpi  Dorsale.  This 
ligament  is  extended  from  the  outer  or  styloid  margin  of  the  radius, 
transversely  to  the  inner  margin  of  the  ulna,  to  the  pisiform  bone, 
and  to  the  fifth  metacarpal.  It  consists,  in  some  measure,  of  two 
portions:  of  which  the  superior  is  the  smaller  and  thinner,  has  its 
fibres  descending  from  the  radius  to  the  ulna,  and  is  crossed,  in  part, 
by  the  fibres  of  the  inferior  or  greater  portion.  As  this  ligament 
adheres  with  great  strength  to  the  ridges  on  the  back  of  the  bones  of 
the  fore  arm,  six  trochleae  for  the  tendons  of  the  extensor  muscles 
are  thus  formed.  The  first,  or  that  next  to  the  styloid  process  of  the 
radius,  contains  the  tendons  of  the  first  two  extensors  of  the  thumb. 
The  second  is  larger,  and  transmits  the  tendons  of  the  two  radial 
extensors  of  the  carpus.  The  third  is  small  and  oblique,  for  the  ten- 
don of  the  third  extensor  of  the  thumb.  The  fourth  is  the  largest, 
and  is  for  the  tendons  of  the  extensor  communis  of  the  fingers  and 
that  of  the  indicator.  The  fifth  is  between  the  radius  and  the  head 
of  the  ulna,  and  is  for  that  tendon*  of  the  extensor  communis  which 
goes  to  the  little  finger.  The  sixth  is  on  the  back  of  the  ulna,  and 
is  for  the  tendon  of  the  extensor  carpi  ulnaris. 

The  inferior  margin  of  this  dorsal  ligament  of  the  wrist  does  not 
terminate  abruptly,  but  resuming  its  fascia-like  character,  is  continued 
over  the  back  of  the  wrist,  and  over  that  of  the  hand  to  the  fingers. 
In  this  progress  it  furnishes  an  envelop  to  the  extensor  tendons,  and 
is  very  much  blended  with  the  oblique  fasciculi,  by  which  they  com- 
municate with  each  other. 


412  MUSCLES. 

The  Fascia  Brachialis  affords  origin,  in  part,  to  the  muscles  on  the 
dorsuin  of  the  scapula  below  its  spine;  on  the  arm  it  is  not  so  inti- 
mately connected  with  the  muscles,  but  on  the  fore  arm  they  again 
begin  to  arise,  in  part,  from  it.  In  its  whole  course  partitions,  consti- 
tuting the  sheaths  of  the  muscles,  and  which  consist,  for  the  most  part, 
of  common  cellular  and  adipose  membrane,  go  from  it  down  to  the 
periosteum  and  inter-osseous  ligament.  It  adheres  very  tightly  to  the 
ulna,  from  the  olecranon  to  the  styloid  process.  On  its  cutaneous  sur- 
face are  found  all  the  superficial  veins,  nerves,  and  lymphatics  of  the 
arm.  Bichat  considers  this  membrane  as  the  best  example  of  the  con- 
tinuity of  ligamentous  with  cellular  tissue,  and  consequently  of  the 
affinity  of  the  two,  a  fact  now  sufficiently  proved  by  the  microscope. 

The  flexor  tendons  of  the  hand  and  fingers  are  held  down  by  the 
Ligamentum  Carpi  Volare  or  the  Anterior  Annular  Ligament  of  the 
Wrist.  It  is  a  very  strong  fasciculus  of  ligamentous  fibres,  which  sub- 
tends the  concavity  of  the  carpal  bones  in  front,  and  converts  it  into 
the  large  oval  foramen  which  contains  the  tendons.  It  is  attached  by 
one  end  at  the  ulnar  side  of  the  wrist,  to  the  hook-like  process  of 
the  unciforme  and  to  the  cuneiforme  ;  also,  but  more  slightly,  to  the 
pisiforme.  Its  fibres  go  straightly  across  the  wrist  to  be  attached 
by  their  other  extremities  to  the  radial  end  of  the  trapezium,  and  of 
the  scaphoides ;  and  may  be  readily  distinguished  from  the  fascia 
brachialis  by  their  uniformly  transverse  course  ;  by  their  superior 
whiteness ;  by  their  increased  thickness  ;  and  by  their  great  strength 
and  unyielding  nature.  Yet  the  superior  margin  of  this  ligament  is  par- 
tially continuous  with  the  fascia  ante-brachialis,  and  the  inferior  margin 
with  the  aponeurosis  palmaris.  Several  of  the  little  muscles  of  the 
hand  arise  from  its  front  surface,  while  the  posterior  is  in  contact  with 
the  flexor  tendons. 

The  Fascia  or  Aponeurosis  Palma-ris  is  placed  just  below  the  skin, 
adhering  firmly  and  closely  to  it,  and  covers  the  middle  of  the  palm 
of  the  hand.  It  is  triangular,  and  has  its  apex  above,  where  it  arises 
from  the  inferior  margin  of  the  volar  or  anterior  annular  ligament  of 
the  wrist,  and  from  the  tendon  of  the  palmaris  longus;  it  spreads  out 
in  its  descent,  and  reaches  the  lower  ends  of  the  metacarpal  bones, 
where  it  is  divided  into  four  portions,  the  vessels  and  nerves  pass  to 
the  fingers  between  these  primary  divisions  of  the  aponeurosis.  Each  of 
these  portions  bifurcates,  and  passes  to  the  head  of  its  appropriate  meta- 
carpal bone,  to  be  fixed  to  it  just  in  advance  of  the  inferior  palmar  liga- 
ments. The  vacuity  of  the  bifurcation  permits  the  flexor  tendons  to  pass 
to  the  finger,  and  its  branches  are  held  together  by  transverse  and  reticu- 
lated fibres,  the  interstices  of  which  are  filled  with  fat.  The  lateral  mar- 
gins of  this  aponeurosis  send  off  a  thin  membrane,  for  the  purpose  of 
covering  the  muscles  of  the  thumb  and  of  the  little  finger  ;  or,  in  other 
words,  the  thenar1  and  the  hypo-thenar  eminences  in  the  palm  of  the 
hand. 

1  From  06»#,  I  strike. 


MUSCLES  OF  THE  SHOULDER.  413 

SECT.  II. — OF  THE  MUSCLES  OF  THE  SHOULDER. 

The  Deltoides 

Is  a  muscle  which  is  extended  over  the  top  of  the  shoulder  joint,  and 
forms  there  the  subcutaneous  cushion  of  flesh  which  protects  and  gives 
rotundity  to  the  articulation.  It  arises  from  the  inferior  edge  of  the 
whole  spine  of  the  scapula,  from  the  outer  circumference  of  the  acro- 
mion  process,  and  from  the  exterior  third  of  the  clavicle.  Its  origin, 
for  the  most  .part,  is  tendinous  and  fleshy  mixed ;  but  at  its  posterior 
part  it  is  entirely  tendinous. 

It  is  inserted,  by  a  tendinous  point,  into  the  triangular  rough  sur- 
face on  the  outer  side  of  the  os  humeri  near  its  middle.  Its  general 
configuration  is  triangular,  and  when  spread  out,  its  upper  margin  is 
much  more  extensive  than  one  would  suppose,  as  it  is  opposed  to  the 
entire  insertion  of  the  trapezius.  Its  fibres  do  not  converge  regularly 
to  its  insertion  like  the  radii  of  a  circle,  but  the  whole  muscle  is  di- 
vided into  several  parts ;  the  interposition  of  inter-muscular  tendons 
into  which,  affecting  the  course  of  the  fibres,  makes  several  portions  of 
the  deltoid  look  penniform,  and  others,  like  smaller  deltoids,  intro- 
duced into  the  larger. 

The  deltoid  covers  the  insertion  of  the  pectoralis  major,  latissimus 
dorsi,  and  teres  major,  besides  that  of  the  other  muscles  of  the  shoul- 
der. It  also  conceals  the  origin  of  the  biceps  flexor  cubiti  and  of  the 
coraco-brachialis.  Its  insertion  is  between  the  triceps  extensor  and 
the  biceps  flexor,  and  above  the  origin  of  the  brachialis  internus.1 

It  raises  the  os  humeri. 

Between  the  superior  edge  of  the  deltoid,  the  acromion  process,  and 
the  subjacent  tendons  on  the  top  of  the  articulation,  there  is  a  large 
Bursa  Mucosa,  which  is  sometimes  partitioned  off  into  two. 

The  Supra-Spinatus  Scapulse 

Arises,  fleshy,  from  the  whole  fossa  supra-spinata,  which  it  fills  up ; 
and  from  its  margins.  Forwards  it  terminates  in  a  thick  robust  tendon 
closely  connected  with  the  capsular  ligament  of  the  joint,  and  which 
passes  under  the  jugum  formed  by  the  articulation  of  the  acromion 
with  the  clavicle. 

It  is  inserted,  tendinous,  into  the  inner  face  of  the  great  tuberosity 
of  the  os  humeri. 

It  raises  the  arm,  and  turns  it  outwards. 

The  Infra-Spinatus  Scapulse 

Arises,  fleshy,  from  all  that  portion  of  the  dorsum  scapulae  below  its 
spine,  from  the  spine  as  far  as  the  cervix,  and  from  the  several  margins 
of  the  fossa  infra-spinata.  Its  fibres  pass  obliquely  to  a  middle  ten- 

'  Varieties.  Sometimes  a  fasciculus  arises  between  the  infra-spinatu?  aud  the  teres  ma- 
jor, or  from  the  inferior  costa  of  the  scapula,  and  joins  itself  to  the  deltoid. 


414  MUSCLES. 

don,  "which  adheres  closely  to  the  capsular  ligament,  and  goes  under 
the  projection  of  the  acromion. 

This  tendon  is  inserted,  into  the  middle  facet  of  the  greater  tube- 
rosity of  the  os  humeri. 

The  infra-spinatus  rolls  the  os  humeri  outwards  and  backwards. 
There  is  a  bursa  between  its  tendon  and  the  scapula. 

The  Teres  Minor 

Is  situated  at  the  inferior  margin  of  the  infra-spinatus,  in  the  fossa 
of  the  inferior  costa  scapulae,  and  looks  very  much  like  a  part  of  the 
infra-spinatus,  to  which  it  occasionally  adheres  so  closely  as  to  be  sepa- 
rated with  difficulty.  It  arises,  fleshy,  from  the  whole  of  the  fossa, 
and  the  margins  of  the  inferior  costa,  in  the  space  from  the  cervix  of 
the  bone  to  within  an  inch  or  so  of  its  angle. 

It  is  inserted  tendinous  and  fleshy,  into  the  outer  facet  of  the  great 
tuberosity  of  the  os  humeri,  just  below  the  infra-spinatus. 

It  draws  the  os  humeri  downwards  and  backwards,  and  rotates  it 
outwards. 

The  Teres  Major 

Is  situated  at  the  inferior  edge  of  the  teres  minor.  It  arises,  fleshy, 
from  the  posterior  surface  of  the  angle  of  the  scapula,  and  from  a 
small  part  of  its  inferior  costa ;  the  interstice  between  it  and  the  teres 
minor  is  considerable. 

It  is  inserted,  by  a  broad  tendon,  into  the  internal  ridge  of  the 
groove  of  the  os  humeri,  along  with  the  tendon  of  the  latissimus  dorsi. 
Their  tendons,  at  first,  are  closely  united,  but  afterwards  there  is  an 
intermediate  cavity  lubricated  with  synovia.  The  tendon  of  the  latis- 
simus dorsi  is  anterior,  and  the  lower  edge  of  the  tendon  of  the  teres 
extends  farther  down  the  arm  than  it. 

It  rolls  the  os  humeri  inwards,  and  draws  it  downwards  and  back- 
wards. 

The  Sub-Scapularis 

Occupies  all  the  thoracic  surface  of  the  scapula,  being  between  it 
and  the  serratus  major.  It  arises,  fleshy,  from  the  whole  base,  supe- 
rior and  inferior  costa,  and  costal  surface  of  the  scapula ;  it  is  divided 
into  several  columns,  which  look  somewhat  like  distinct  muscles,  but 
they  all  terminate  in  a  thick  robust  tendon  that  adheres  to  the  inferior 
surface  of  the  capsular  ligament. 

This  tendon  is  inserted  into  the  lesser  tuberosity  of  the  os  humeri. 

The  subscapularis  rolls  the  bone  inwards  and  draws  it  downwards. 
Between  it  and  the  neck  of  the  scapula,  there  is  a  bursa,  which,  as 
mentioned,  communicates  with  the  articulation. 


MUSCLES  OF  THE  ARM. 


415 


SECT.  III. —  OF  THE  MUSCLES  OF  THE  ARM. 

The  Biceps  Flexor  Cubiti. 

This  muscle  is  just  beneath  the  fascia  and  integuments,  and  forms 
the  swell  so  obvious  in  the  middle  front  part  of  the  arm.  It  arises  by 
two  heads.  The  first,  called  the  long,  is  a  round  tendon  which  comes 
from  the  superior  extremity  of  the  glenoid  cavity  of  the  scapula,  passes 
through  the  shoulder  joint  and  through  the  groove  of  the,  os  humeri ; 
the  second  head  arises  tendinous  from  the  extremity  of  the  coracoid 
process  of  the  scapula,  in  company  with  the  coraco-brachialis  muscle. 
The  fleshy  bellies  in  which  these  tendons  terminate  unite  with  each 
other,  several  inches  below  the  shoulder  joint,  to  form  a  common 
muscle.  At  first  they  are  only  connected  by  loose  cellular  substance  ; 
but,  about  half  way  down  the  arm,  they  are  inseparably  united. 

The  biceps  terminates  below  in  a  flattened  cylindrical  tendon,  which 

Fig.  129. 


A  view  of  the  Mil  sol  PS  on  the  Front  of  the  Arm.— 1.  Clnyicle.  2.  Corncoid  process  ?:m!  origin  of 
the  sliort.  head  of  the  biceps.  3.  Acromion  scapula.  4.  Head  of  tin-  us  hinneri.  ',.  f endon  of  the 
biceps  muscle  in  the  bicipital  groove.  G.  Ligamentum  ascititium  ilissee'.H  oif.  ?.  Cut  portion  of  the 
pectoralis  major.  8.  Long  head  of  the  biceps.  9.  Insertion  of  the  deltoid.  10.  Cut  portion  of  the 
tendinous  insertion  of  the  pectoralis  minor.  11.  Coraco-br;ichi:ilis  12.  Short  head  of  the  bleeps-. 
13.  Latissimus  dorsi.  14.  Inner  portion  of  the  triceps.  15.  Body  of  the  biceps.  10.  Outer  portion  of 
the  triceps.  -"17.  Brachialis  intermis.  18.  Origin  of  the  flexor  m'nseles.  19.  Brnchialis  interims  mar 
its  insertion.  20.  Tendon  of  the  biceps.  21. "Fasciculus  from  the  biceps  tendon  to  the  fascia  ante- 
brachiahs.  22.  Flexor  carpi  radial  is.  '23.  Palmaris  longua.  24.  Supinator  radii  longns. 


416  MUSCLES. 

passes  in  front  of  the  elbow  joint,  to  be  inserted  into  the  posterior  rough 
part  of  the  tubercle  of  the  radius.  A  bursa  mucosa  is  placed  between 
the  tendon  and  the  front  of  the  tubercle,  the  surface  of  the  latter  being 
covered  with  cartilage.  From  the  ulnar  side  of  this  tendon  proceeds 
the  aponeurosis  running  into  that  of  the  fore  arm. 

The  relative  position  of  the  biceps  is  as  follows.  Its  long  head  is  first 
within  the  cavity  of  the  capsular  ligament,  and  then  between  the  ten- 
dons of  the  latissimus  dorsi  and  teres  major  behind,  and  pectoralis 
major  in  front ;  where  it  is  bound  down  by  strong  ligamentous  fibres. 
The  tendon  below  is  superficial,  and  may  be  easily  felt  by  flexing  the 
fore  arm,  but  its  insertion  dips  down  between  the  pronator  teres  and 
supinator  radii  longus. 

This  muscle  flexes  the  fore  arm.1 

The  Coraco-Brachialis 

Is  situated  on  the  upper  internal  side  of  the  arm,  at  the  inner  edge 
of  the  short  head  of  the  biceps  muscle,  with  which  it  is  connected  for 
three  or  four  inches.  It  arises  tendinous  and  fleshy  from  the  middle 
facet  of  the  point  of  the  coracoid  process  of  the  scapula,  and  in  com- 
mon with  the  short  head  of  the  biceps  muscle. 

It  is  inserted,  tendinous  and  fleshy,  into  the  internal  side  of  the  mid- 
dle of  the  os  humeri,  by  a  rough  ridge,  just  below  the  tendons  of  the 
latissimus  dorsi  and  teres  major,  and  in  front  of  the  brachialis  externus 
or  third  head  of  the  triceps.  The  lower  end  of  this  muscle  is  attached 
to  the  inter-muscular  ligament  of  the  internal  side  of  the  os  humeri, 
which  separates  the  brachialis  internus  from  the  third  head  of  the 
triceps. 

This  muscle  draws  the  arm  upwards  and  forwards.2 

The  Brachialis  Internus 

Is  situated  immediately  beneath  the  biceps,  and  is  concealed  by  it, 
excepting  its  outer  edge.  It  has  a  bifurcated  fleshy  origin  from  the 
middle  front  face  of  the  os  humeri,  on  each  side  of  the  insertion  of  the 
deltoid,  and  its  origin  is  continued  fleshy  from  this  point  downwards, 
from  the  whole  front  of  the  bone  to  within  a  very  small  distance  of  its 
articular  surface. 

It  is  inserted  by  a  strong  short  tendon  into  the  rough  surface  at  the 
root  of  the  coronoid  process  of  the  ulna.  A  bursa  sometimes  exists  be- 
tween the  tendon  of  the  brachialis  internus,  that  of  the  biceps,  the 
supinator  brevis,  and  the  elbow  joint. 

The  brachialis  flexes  the  fore-arm,  and,  by  passing  in  front  of  the 

1  Varieties.     Sometimes  the  division  of  the  muscle  is  continued  to  the  elbow;  sometimes 
there  is  a  third  head,  coming  either  from  the  internal  face  of  the  os  humeri,  or  from  the 
brachialis  internus;  very  rarely,  the  number  of  heads  has  been  multiplied  to  five,  thereby 
making  a  close  approximation  to  the  arrangement  in  birds.     This  muscle  is  very  liable  to 
anomalies. 

2  Varieties.    This  muscle  being  generally  penetrated  by  the  musculo-cutaneous  nerve,  the 
perforation  thus  made  sometimes  exists  as  a  fissure,  extending  the  length  of  the  lower  half 
of  the  muscle ;  on  other  occasions  the  fissure  is  so  long  as  to  divide  the  muscle  completely  into 


MUSCLES  OF  THE  ARM.  417 

elbow  joint,  strengthens  the  latter  very  much.  Its  lower  part  lies 
under  the  tendon  of  the  biceps,  and  between  the  pronator  teres  and  the 
supinator  longus.1 

The  Triceps  Extensor  Cubiti,  or  Brachii, 

Forms  the  whole  of  the  fleshy.mass  on  the  back  of  the  arm  ;  it  there- 
fore occupies  the  space  between  the  integuments  and  the  bone.  It 
arises  by  three  heads.  The  first,  called  Longus,  comes  by  a  flattened 
tendon,  between  the  teres  major  and  minor  muscles,  from  a  rough  ridge 
on  the  inferior  edge  of  the  cervix  scapulae.  The  second,  called  the 
Brevis,  arises  by  a  sharp,  tendinous,  and  fleshy  beginning,  from  a  slight 
ridge  on  the  outer  back  part  of  the  os  humeri,  just  below  its  head.  The 
third  head,  called  Brachialis  Externus,  arises,  by  an  acute  fleshy  begin- 
ning from  the  inner  side  of  the  os  humeri  near  the  insertion  of  the 
teres  major.  This  muscle,  both  at  its  external  and  internal  edge,  is 
separated  from  the  muscles  in  front  of  the  arm  by  the  external  and  in- 
ternal inter-muscular  ligaments,  which  begin  near  the  middle  of  the  os 
humeri,  and  run  to  the  condyles  respectively.  The  whole  back  of  the 
os  humeri,  and  the  posterior  surface  of  these  inter-muscular  septa,  are 
occupied  by  the  origin  of  the  triceps.  The  muscular  fibres  run  in  vari- 
ous directions,  according  to  their  respective  heads  and  places  of  origin. 

At  the  inferior  end  of  the  muscle  is  found  a  broad  tendon,  which 
covers  its  posterior  face.  This  tendon  is  inserted  into  the  base  or  back 
part  of  the  olecranon,  and  the  ridge  leading  down  the  ulna  on  its  radial 
side.  The  bellies  of  the  triceps  unite  above  the  middle  of  the  os  humeri, 
but  the  interstices  between  them  may  be  observed  much  lower  down. 
There  is  a  bursa  between  the  tendon  and  the  olecranon  process;  besides 
which,  there  is  sometimes  another  on  each  side  of  the  first. 

The  triceps  extends  the  fore  arm. 

The  Anconeus 

Is  a  small  triangular  muscle,  just  beneath  the  skin,  at  the  outer  pos- 
terior part  of  the  elbow  joint.  It  arises  tendinous  from  the  posterior 
lower  part  of  the  external  condyle  of  the  os  huineri,  adheres  to  the  cap- 
sular  ligament  of  the  joint,  and  is  partly  covered  by  the  tendon  of  the 
triceps. 

It  is  inserted,  fleshy  and  thin,  into  the  ridge  leading  from  the  ole- 
cranon, on  the  outer  part  of  the  upper  end  of  the  ulna,  and  into  the 
triangular  depression  found  there,  so  as  to  fill  it  up. 

It  extends  the  fore  arm. 

1  Varieties.  Sometimes  at  its  external  margin,  there  exists  a  smaller  brachialis  internus 
muscle,  which  arises  from  about  the  same  point  of  the  os  humeri,  and  is  inserted  into  the 
same  part  of  the  ulna.  Sometimes  it  detaches  a  fasciculus  which  joins  the  biceps  muscle. 
Sometimes  its  posterior  part  is  distinct  from  the  anterior.  JSometimes  a  fasciculus  of  it  runs 
along  the  supinator  longus  of  the  fore  arm. 

VOL.  i. — 27 


418 


MUSCLES. 


SECT.  IV. — OF  THE  MUSCLES  OF  THE  FOKE  AEM. 

There  are  eight  muscles  on  the  front  of  the  fore  arm,  some  of  which 
are  superficial,  and  others  deep-seated.  They,  for  the  most  part,  are 
either  directly  or  indirectly  flexors  of  the  fore  arm  and  hand,  and  in 
their  origin  adhere  very  much  by  the  tendinous  partitions,  called  Inter- 
muscular  Ligaments. 


1.   The  Pronator  Radii  Teres 

Is  just  beneath  the  fascia  of  the  fore  arm,  and  forms  the  radial  side 
of  the  muscles  of  the  internal  condyle.  It  arises,  fleshy,  from  the  ante- 
rior face  of  the  internal  condyle  of  the  os  humeri,  and  tendinous  from 
the  coronoid  process  of  the  ulna.  It  passes  very  obliquely  across  the 
fore  arm,  at  the  internal  edge  of  the  brachialis  internus  muscle,  and  is 
inserted,  tendinous  and  fleshy,  into  the  external  back  part  of  the  radius, 

Fig.  130. 


Superficial  layer  of  the  Muscles  of  the  Fore  arm. — 1.  The  lower  part  of  the  biceps,  with  its  tendon. 
2.  A  part  of  the  brachialis  internus,  seen  beneath  the  biceps.  3.  A  part  of  the  triceps.  4.  The  pronator 
radii  teres.  5.  The  flexor  carpi  radialis.  6.  The  palmaris  longus.  7.  One  of  the  fasciculi  of  the 
flexor  sublimis  digitorum;  the  rest  of  the  muscle  is  seen  beneath  the  tendons  of  the  palmaris  longus 
nrid  flexor  carpi  radialis.  8.  The  flexor  carpi  ulnaris.  9.  The  palmar  fascia.  10.  The  palmaris 
brevis  muscle.  11.  The  abductor  pollicis  muscle.  12.  One  portion  of  the  flexor  brevis  pollicis;  the 
leading  line  crosses  a  part  of  the  adductor  pollicis.  13.  The  supinator  longus  muscle.  14.  The  extensor 
oasis  metacarpi,  and  extensor  prhni  iuternodii  pollicis,  curving  around  the  lower  border  of  the  fore 
arm. 


MUSCLES  OF  THE  FORE  ARM.  419 

just  below  the  insertion  of  the  supinator  radii  brevis,  so  as  to  occupy 
about  two  inches  of  the  middle  of  the  bone. 
It  rolls  the  hand  inwards.1 

2.   The  Flexor  Manus,  vel  Carpi  Radialis, 

Is  placed  at  the  ulnar  side  of  the  last  muscle,  and  is  also  superficial. 
It  arises,  by  a  narrow  tendon,  from  the  lower  front  part  of  the  internal 
condyle  of  the  os  humeri,  fleshy  from  the  inter-muscular  ligaments,  the 
ante-brachial  fascia,  and  from  the  upper  part  of  the  ulna.  It  forms  a 
thick  fleshy  belly,  terminating  below  in  a  tendon,  which  passes  under 
the  anterior  annular  ligament  of  the  wrist,  in  a  canal  of  its  own,  formed 
over  the  outer  end  of  the  scaphoid  bone,  and  through  the  groove  in  the 
os  trapezium. 

It  is  inserted,  tendinous,  into  the  base  of  the  metacarpal  bone  of  the 
fore  finger,  in  front,  having  to  bend  over  deeply  to  get  there. 

There  is  a  bursa  between  the  lower  extremity  of  its  tendon  and  the 
trapezium ;  the  tendon  is  there  held  down  by  ligainentous  fibres. 

It  bends  the  hand,  and  draws  it  towards  the  radius. 

3.   The  Palmar  is  Longus 

Is  at  the  ulnar  side  of  the  flexor  carpi  radialis,  and  is  superficial.  It 
is  a  small  short  muscle,  terminating  in  a  long  slender  tendon,  and  arises 
by  a  small  tendon  from  the  internal  condyle,  and  fleshy  from  the  inter- 
muscular  ligament  on  each  of  its  sides. 

It  is  inserted,  tendinous,  into  the  anterior  face  of  the  ligamentum 
carpi  annulare  anterius,  near  the  root  of  the  thumb ;  and  a  division  of 
its  tendon  passes  on  to  the  aponeurosis  palmaris.  Its  tendon  escapes 
about  half  way  down  the  fore  arm,  from  confinement  beneath  the  ante- 
brachial  fascia.  Hence  it  springs  up  in  the  contraction  of  the  muscle. 

It  bends  the  hand,  and  makes  tense  the  palmar  aponeurosis.2 

4.  The  Flexor  Manus,  vel  Carpi  Ulnaris, 

Occupies,  among  the  superficial  muscles,  the  ulnar  side  of  the  fore 
arm.  It  arises,  tendinous,  from  the  internal  condyle  of  the  os  humeri, 
fleshy  from  the  upper  internal  side  of  the  olecranon,  and  by  a  tendi- 
nous expansion,  being  a  part  of  the  fascia  of  the  fore  arm,  from  the 
ridge  at  the  internal  side  of  the  ulna,  to  within  three  or  four  inches  of 
the  wrist. 

It  is  inserted  into  the  upper  side  of  the  os  pisiforme  by  a  round  ten- 
don, which  arises  early  at  the  radial  margin  of  the  muscle,  and  receives 
the  muscular  fibres.  The  tendon  is  continued  from  the  os  pisiforme,  so 
as  to  be  likewise  inserted  into  the  unciform  process  of  the  unciforme 
and  into  the  base  of  the  metacarpal  bone  of  the  little  finger.  There 
is  a  loose  bursa  at  the  junction  of  the  tendon  with  the  pisiforme. 

It  bends  the  hand,  and  draws  it  towards  the  ulna. 

1  Varieties.     Sometimes  it  is  double. 

2  Varieties.     Sometimes  it  is  deficient  in  both  arms ;  sometimes  the  middle  part  only  is 
fleshy;  sometimes  the  belly  goes  almost  to  the  wrist. 


420 


MUSCLES. 


5.  The  'Flexor  Digitorum  Sublimis  Perforatus 

Is  concealed  very  much  by  the  muscles  just  enumerated,  in  conse- 
quence of  being  placed  between  them.  To  get  a  good  view  of  its 
origin,  they  all  should  be  cut  away  from  the  os  humeri.  It  arises,  ten- 
dinous and  fleshy,  from  the  internal  condyle  of  the  os  humeri,  tendi- 
nous from  the  coronoid  process  of  the  ulna,  and  fleshy  from  the  tubercle 
of  the  radius ;  the  latter  part  of  its  origin  being  extended,  tendinous 
obliquely,  for  three  or  four  inches  from  that  line  of  the  radius  which  is 
at  the  insertion  of  the  supinator  radii  brevis.  With  these  origins,  the 
muscle  spreads  over  the  front  of  the  fore  arm  at  its  upper  part,  from 
the  radial  to  the  ulnar  margin. 

Four  distinct  tendons  arise  from  the  lower  end  of  the  muscle,  which 
commence  much  above  the  wrist,  pass  beneath  its  anterior  ligament, 
and,  having  reached  the  palm  of  the  hand,  diverge  to  the  several  fin- 
gers. A  tendon  is  appropriated  to  each  finger,  and  passes  in  front 
of  its  metacarpal  bone  to  the  phalanges,  being  inserted  after  having 
split  into  two,  into  the  angle  formed  on  each  side  by  the  junction  of 
the  cylindrical  and  flat  surface  of  the  second  phalanx  near  its  middle. 

It  bends  the  second  phalanges  on  the  first ;  its  action  may  also  be 
continued  so  as  to  clench  the  hand  and  to  bend  it  on  the  fore  arm.1 

6.    The  Flexor  Digitorum  JProfundus  Perforans 

Is  beneath  the  flexor  sublimis  and  the  flexor  ulnaris.  It  arises, 
fleshy,  from  the  oblong  concavity  of  the  ulna,  along  the  inner  side  of 
the  coronoid  and  of  the  olecranon  process,  fleshy  from  the  lower 
margin  of  the  base  of  the  coronoid  process,  from  the  ulnar  portion  of 
the  interosseous  ligament,  and  from  the  front  of  the  upper  two-thirds 
of  the  ulna. 

Fig.  131. 


The  Metacarpal  and  Phalangial  Bones  of  two  fingers,  with  the  tendons.  In  the  first  figure  the  ten- 
dons of  the  flexor  muscle  are  bound  to  the  finger  by  the  fibrous  bands;  in  the  second  they  are  freed 
from  that  structure,  as  well  as  from  the  synovial  membrane  and  the  vincula  accessoria.  1.  Metacar- 
pal bone.  a.  Tendon  of  flexor  sublimis.  3.  Tendon  of  flexor  profundus.  *  The  perforation  of  the 
former  by  the  latter.  4.  Tendon  of  extensor  digitorum  communis.  5.  A  lumbricalis  muscle.  6.  An 
interosseouB  muscle. 

1  Varieties.  The  tendon  to  the  little  finger  is  sometimes  wanting,  in  which  case  the  defi- 
ciency is  supplied  by  the  tendon  of  the  flexor  profundus.  Sometimes  the  section  of  this 
muscle  which  belongs  to  the  fore  finger  is  insulated  from  the  rest  of  it  by  a  long  fissure,  and, 
moreover,  divided  by  a  middle  tendon  into  two  fleshy  portions. 


MUSCLES  OF  THE  FORE  AKM.  421 

The  tendons  of  this  muscle  are  different  from  those  of  the  other ; 
they  commence  in  front  of  it,  like  a  tendinous  membrane,  which  is 
gradually  divided  into  several  fasciculi,  adhering  to  each  other  by  cel- 
lular membrane.  The  fasciculated  character  of  the  tendons  is  still 
preserved  when  they  go  under  the  anterior  carpal  ligament,  and  until 
they  begin  to  disperse  as  distinct  tendons  to  each  of  the  fingers. 

Each  tendon,  going  in  front  of  its  metacarpal  bone  and  of  the  cor- 
responding phalanges,  gets  through  the  slit  in  the  flexor  sublimis,  and 
is  inserted  into  the  front  part  of  the  root  of  the  third  phalanx  of  its 
respective  finger. 

It  bends  the  last  phalanges  of  the  fingers,  and  may,  by  increased 
action,  flex  the  hand  like  the  preceding  muscle.1 

7.   The  Flexor  Longus  Pollicis 

Lies  in  front  of  the  radius,  but  beneath  the  flexor  sublimis.  It  arises 
by  an  acute  fleshy  beginning,  from  the  radius  just  below  its  tubercle ; 
also  fleshy  from  the  middle  two-thirds  of  the  front  of  this  bone,  and 
from  the  radial  portion  of  the  interosseous  ligament.  The  body  of  the 
muscle  is  joined  by  a  small  fleshy  slip,  having  a  tendinous  origin  from 
the  internal  condyle  of  the  os  hurneri. 

A  tendon  is  formed  early  on  the  ulnar  margin  of  this  muscle,  and  to 
which  the  fibres  pass  obliquely.  The  tendon  goes  under  the  annular 
ligament  of  the  wrist,  through  the  fossa  formed  in  the  short  flexor  mus- 
cle of  the  thumb,  and  between  the  sesamoid  bones,  to  be  inserted  into 
the  base  of  the  second  phalanx  of  the  thumb. 

From  the  inferior  end  of  the  fore  arm  to  the  middle  of  the  first 
phalanx,  the  tendon  is  invested  by  its  appropriate  bursa. 

It  bends  the  last  joint  of  the  thumb.2 

The  several  flexor  tendons,  as  they  pass  under  the  anterior  annular 
ligament  of  the  wrist,  are  surrounded  by  the  superior  Bursa  Mucosa. 
It  begins  about  an  inch  and  a  half  above  the  radio-carpal  articulation, 
and  extends  to  the  lower  margin  of  the  annular  ligament.  It  adheres 
by  its  circumference  to  this  ligament  and  to  the  capsule  of  the  joint ; 
within,  it  sends  in  a  considerable  number  of  processes,  whereby  each 
tendon  is  surrounded,  and  connected  to  the  adjoining  tendons;  while 
at  the  same  time  no  restraint  is  put  upon  the  natural  motions  of  the 
part.  In  its  texture  this  bursa  resembles  a  dense  and  elastic  cellular 
membrane. 

In  addition  to  this,  the  flexor  tendons,  as  they  pass  from  the  root  to 
the  extremity  of  each  finger,  are  surrounded  by  a  synovial  bursa  ;  which 
by  its  secretion  continually  lubricates  them,  and  permits  them  to  play 
freely  backwards  and  forwards,  according  to  the  flexions  and  extensions 
of  the  fingers.  These  mucous  or  synovial  sheaths  begin  a  little  dis- 
tance above  the  first  joint  of  the  finger,  adhere  there  to  both  flexor 

1  Varieties.     Sometimes  a  distinct  fasciculus  comes  from  the  internal  condyle  to  join  it; 
sometimes  a  fasciculus  comes  from  the  flexor  longus  pollicis,  and  terminating  in  a  tendinous 
expansion,  is  inserted  into  the  tendons  which  the  flexor  profundus  sends  to  the  fore  finger. 

2  The  last  two  muscles  adhere  only  to  inconsiderable  extent  to  the  interoSseous  ligament, 
for  the  more  central  portion  of  the  latter  is  comparatively  free. 


422  MUSCLES. 

tendons,  and  extend  to  about  the  middle  of  the  last  phalanx.  They 
give  to  the  tendons  a  very  polished  lubricated  surface ;  are  reflected 
over  the  anterior  flat  faces  of  the  phalanges,  being  separated  partially 
from  them  by  a  small  quantity  of  adipose  matter :  they  are  also  re- 
flected over  the  anterior  faces  of  the  capsular  ligaments,  and  line  the 
vaginal  ligaments. 

The  Vaginal  Ligaments  of  the  fingers  (ligamenta  vaginalia)  bind 
down  the  flexor  tendons,  and  keep  them  applied  to  the  fronts  of  the 
phalanges.  They  are  of  the  same  extent  from  above  downwards,  with 
the  mucous  sheaths  just  mentioned,  and  are  stretched  between  the  ulnar 
and  the  radial  margins  of  the  phalanges.  The  fibres  of  which  they 
consist  pass  for  the  most  part  transversely,  and  are  of  a  fibro-cartilagi- 
nous  character.  These  fibres  diminish  in  number  towards  the  end  of 
each  finger,  and  are  stronger  on  the  fore  finger  than  on  any  of  the 
others.  In  front  of  the  first  joints  or  the  metacarpo-phalangial  articu- 
lations, and  the  phalangial  articulations,  the  vaginal  ligaments  are 
much  thinner  than  elsewhere,  in  order  to  permit  the  free  flexion  of  the 
fingers.  The  structure,  indeed,  at  these  points  is  decidedly  marked  off 
by  its  diminished  thickness,  and  though  the  course  of  the  fibres  is  the 
same  from  side  to  side,  yet  some  anatomists  have  thought  it  worth 
while  to  designate  it  particularly  under  the  name  of  Annuli  Junctura- 
rum  Ligamentosi. 

Within  the  vaginal  ligaments  small  frsena  arise  from  the  first  and 
second  phalanges ;  they  vary  in  number  in  different  individuals,  and 
run  obliquely  forwards,  some  to  terminate  in  the  flexor  profundus  ten- 
dons, and  others  in  those  of  the  flexor  sublimis ;  they  are  called  Vin- 
cula  Accessoria,  and  are  covered  by  a  reflection  of  the  synovial  sheath. 
Indeed,  they  seem  to  be  formed  almost  entirely  from  the  latter. 

8.   The  Pronator  Quadratus 

Is  just  above  the  carpal  surfaces  of  the  radius  and  ulna,  and  between 
the  other  muscles  and  the  bone.  In  the  adult  it  is  about  two  inches 
wide,  and  its  fibres  run  across  the  fore  arm.  It  arises,  fleshy  and  ten- 
dinous, from  the  ridge  at  the  inner  surface  of  the  ulna,  near  its  lower 
extremity,  and  from  the  front  of  the  bone. 

It  is  inserted  into  the  corresponding  front  surface  of  the  radius. 

It  rotates  the  radius  inwards.1 

Of  the  Muscles  on  the  back  of  the  Fore  Arm. 

These  muscles  are  ten  in  number.  They  arise,  for  the  most  part, 
from  the  external  condyle,  or  the  ridge  leading  to  it,  and  are  extensors 
either  of  the  fore  arm,  or  of  the  fingers  and  thumb.  Their  origins  are 
less  blended  with  each  other  than  those  of  the  flexor  muscles  ;  never- 
theless, between  several  of  them  there  are  inter-muscular  ligaments 
which  connect  them.  They  are  superficial  and  deep-seated. 

1  Varieties.  This  muscle  in  some  very  rare  cases  does  not  exist.  Sometimes  it  consists 
in  two  layers  whose  fibres  cross  each  other.  In  a  case  noticed  in  the  Pennsylvania  Hospital 
by  Dr.  J.  R.  Barton,  it  consisted  in  two  triangular  pieces,  the  bases  of  which  were  reversed. 


MUSCLES  OF  THE  FORE  ARM. 


423 


1.   The  Supinator  Radii  Longus 

Is  situated  along  the  radial  edge  of  the  fore  arm,  immediately  be- 
neath the  integuments.  It  arises,  fleshy  and  tendinous,  from  the 
higher  part  of  the  ridge  leading  to  the  external  condyle ;  commencing 
just  below  the  insertion  of  the  deltoid  muscle,  and  being  here  placed 
between  the  brachialis  internus  and  the  outer  head  of  the  triceps. 
It  forms  a  thick  fleshy  belly,  constituting  the  external  margin  of  the 
arm,  about  the  elbow  joint;  and  terminates  about  the  middle  of  the 
radius  in  a  flat  tendon. 

It  is  inserted,  by  the  tendon,  into  a  small,  rough  ridge,  on  the  outer 
side  of  the  radius  just  above  its  styloid  process. 

It  rolls  the  radius  outwards. 

Fig.  132. 


The  superficial  layer  of  Muscles  of  the  posterior  aspect  of  the  Fore  Arm.  1.  The  lower  part  of  the 
biceps.  2.  Part  of  the  brachialis  internus.  3.  The  lower  part  of  the  triceps,  inserted  into  theolecra- 
non.  4.  The  supinator  longus.  5.  The  extensor  carpi  radialis  longior.  6.  The  extensor  carpi  radialis 
brevior.  7.  The  tendons  of  insertion  of  these  two  muscles.  8.  The  extensor  communis  digitorum.  9. 
Musculus  auricularis.  10.  The  extensor  carpi  ulnaris.  11.  The  anconeus.  12.  Part  of  the  flexor 
carpi  ulnaris.  13.  The  extensor  ossis  metacarpi  and  extensor  primi  internodii  muscle,  lying  together. 
14.  The  extensor  secundi  internodii ;  its  tendon  is  seen  crossing  the  two  tendons  of  the  extensor  carpi 
radialis  longior  and  brevior.  15.  The  posterior  annular  ligament.  The  tendons  of  the  common  exten- 
sor are  seen  upon  the  back  of  the  hand,  and  their  mode  of  distribution  on  the  dorsum  of  the  fingers. 


2.   The  Extensor  -Carpi  Radialis  Longior 

Is  situated  beneath  the  former   muscle.     It  arises  tendinous  and 
fleshy,  from  the  space  of  the  external  ridge  of  the  os  humeri,  between 


424  MUSCLES. 

the  supinator  longus  and  the  external  condyle.  It  forms  a  short, 
fleshy  belly,  which  terminates  in  a  flat  tendon  above  the  middle  of  the 
adius. 

It  is  inserted,  by  this  tendon,  into  the  posterior  part  of  the  root  of 
the  metacarpal  bone  of  the  fore  finger,  near  the  thumb. 

The  tendon  of  this  muscle  is  surrounded  by  a  synovial  sheath,  at 
the  place  where  it  passes  the  lower  end  of  the  radius,  under  the  poste- 
rior carpal  ligament.  Another  bursa  exists,  also,  at  its  insertion ; 
which,  on  one  occasion,  I  found  so  much  enlarged  in  a  young  woman, 
as  to  require  its  extirpation;  the  operation  was  fully  successful. 

It  extends  the  hand.1 


3.   The  Extensor  Carpi  Radialis  Brevior 

Is  beneath  the  last,  but  projects  somewhat  beyond  it.  It  arises, 
tendinous,  from  the  posterior  and  lower  part  of  the  external  condyle, 
and  from  the  external  lateral  ligament  of  the  elbow  joint.  It  forms  a 
thick,  fleshy  belly,  placed  along  the  radius,  and  terminates  in  a  flat 
tendon  about  the  middle  of  that  bone. 

Its  tendon,  becoming  rounded,  is  inserted  into  the  posterior  part  of 
the  base  of  the  metacarpal  bone  of  the  second  finger,  and  has  a  bursa 
beneath  its  insertion,  and  another  at  the  wrist.  . 

It  extends  the  hand.2 

•« 
4.   The  Extensor  Carpi  Ulnaris 

Is  superficial,  and  placed  principally  parallel  with  the  ulna.  It 
arises,  tendinous,  from  the  external  condyle,  fleshy  from  the  inter-mus- 
cular ligament,  and  the  interior  of  the  ante-brachial  fascia  as  it  is  at- 
tached along  the  ulna.  Crossing  very  obliquely  the  upper  part  of  the 
radius  and  the  ulna,  it  also  arises  fleshy  from  the  back  part  of  the 
latter  bone.  Its  fibres  terminate  obliquely  in  a  tendon  which  goes 
through  the  groove  of  the  ulna,  and  is  there  furnished  with  a  bursa. 

It  is  inserted,  by  its  tendon,  into  the  ulnar  side  of  the  base  of  the 
metacarpal  bone  of  the  little  finger. 

It  extends  the  hand.3 

5.   The  Extensor  Digitorum  Oommunis 

Is  superficial,  being  placed  beneath  the  extensor  ulnaris  and  the 
extensor  radialis  brevior.  It  arises,  tendinous,  from  the  external  con- 
dyle, and  fleshy  from  the  inter-muscular  ligament  of  the  contiguous 
muscles.  As  it  approaches  the  wrist,  it  sends  off  four  tendons,  which 
pass  together  through  a  common  groove  on  the  back  of  the  radius. 

I  '  Varieties.     Sometimes  a  small  fasciculus  is  detached  from  its  posterior  margin,  and  has 

a  tendinous  insertion  into  the  third  metacarpal  bone. 

2  Varieties.     Sometimes  this  muscle  is  so  blended  with  the  preceding  as  to  be  in  common 
with  it. 

3  Varieties.     Sometimes  its  tendon  is  joined,  by  a  small  fasciculus,  to  the  extensor  tendon 
of  the  little  finger. 


MUSCLES  OF  THE  FORE  ARM.  425 

On  the  back  of  the  hand  these  tendons  diverge,  and  near  the  roots  of 
the  fingers  are  connected  by  cross  slips  to  each  other. 

Each  tendon  goes  to  its  respective  finger,  and  covers  the  whole  pos- 
terior part  of  it,  being  spread  out  into  a  membrane  which  adheres  to 
the  phalanges,  from  the  root  of  the  first  to  the  root  of  the  last.  The 
precise  mode  of  the  insertion  of  these  tendons  is  as  follows  :  on  the 
back  of  the  first  phalanx,  the  lateral  margins  of  these  tendons  are 
joined  by  the  tendons  of  the  lumbricales  arid  interossei ;  and  the  tendi- 
nous membrane,  thus  formed,  simply  adheres  by  condensed  cellular 
membrane  to  the  whole  back  of  the  first  phalanx ;  the  middle  part  of 
this  tendon  then  passes  on  to  be  inserted  near  the  articular  margin  of 
the  base  of  the  second  phalanx  ;  and  the  two  lateral  parts  of  the  tendi- 
nous membrane,  after  keeping  separate  for  some  distance,  unite,  and 
are  jointly  inserted  into  the  back  of  the  base  of  the  third  phalanx. 

The  division  of  this  muscle  appropriated  to  the  little  finger  has  a 
distinct  appearance,  and  frequently  its  tendon  goes  through  a  separate 
fossa  in  the  radius,  or  rather  in  the  posterior  carpal  ligament,  from 
which  causes  it  has  obtained  the  name  of  Musculus  Auricularis.  A 
bursa  invests  these  tendons  at  the  wrist  as  they  pass  through  their 
groove,  and  is  single  above  ;  but,  in  following  the  course  of  the  tendons, 
like  them  it  divides  and  follows  each  tendon  respectively  to  the  base  of 
the  first  phalanx. 

This  muscle  extends  all  the  joints  of  the  fingers,  being  the  antagonist 
of  the  flexors.1 

6.   The  Supinator  Radii  Brevis 

Can  only  be  well  seen  by  detaching  the  origin  of  the  aforesaid 
muscles ;  it  will  then  be  found  in  contact  with  the  radius,  making  a 
close  investment  of  its  head  and  upper  third.  It  arises,  tendinous, 
from  the  external  condyle  of  the  os  humeri,  tendinous  and  fleshy  from 
the  ridge  on  the  posterior  radial  edge  of  the  ulna  which  descends  from 
its  coronoid  process. 

Its  fibres  surround,  obliquely,  the  upper  external  part  of  the  radius, 
and  are  inserted  into  its  tubercle,  and  into  its  oblique  rough  ridge, 
corresponding  with  the  upper  margin  of  the  pronator  teres.  At  the 
interstice  between  the  radius  and  ulna,  near  the  anterior  edge  of  this 
muscle,  a  fleshy  slip  is  occasionally  seen,  which  passes  from  the  radial 
side  of  the  coronoid  process  to  the  ulnar  edge  of  the  radius. 

This  muscle  rotates  the  radius  outwards.2 

7.   The  Extensor  Ossis  Metacarpi  Pollicis  Manus 

Arises,  fleshy,  from  the  posterior  part  of  the  ulna  immediately  below 
the  anconeus,  from  the  interosseous  ligament,  and  from  the  back  part 
of  the  radius  just  below  the  insertion  of  the  supinator  brevis.  It  ter- 

1  Varieties.     It  sometimes  sends  a  double  tendon  to  the  little  finger,  in  which  case  the 
auricularis  is  more  distinct  than  usual,  and  the  tendon  next  to  the  ulna  runs  through  a  distinct 
trochlea  in  the  posterior  carpal  ligament. 

2  Varieties.     Sometimes  the  superior  part  is  separated  from  the  inferior;  sometimes  the 
muscle  is  double. 


426  MUSCLES. 

minates  in  a  rounded  tendon  which  passes  over  the  tendons  of  the  radial 
extensors,  and  through  a  groove  on  the  styloid  side  of  the  lower  end  of 
the  radius.  The  tendon  is  there  invested  by  a  bursa. 

It  is  inserted,  by  its  tendon,  into  the  base  of  the  metacarpal  bone  of 
the  thumb,  and  into  the  external  side  of  the  trapezium. 

It  extends  the  metacarpal  bone  of  the  thumb.1 

8.  The  Extensor  Minor,  or  Primi  Internodii  Pollicis  Manus, 

Is  at  the  ulnar  side  of  the  last  muscle.  It  arises,  fleshy,  from  the 
back  of  the  radius  below  its  middle,  and  from  the  interosseous  ligament. 
Sometimes  tendinous,  also,  from  the  ulna.  It  terminates  in  a  tendon 
which  passes  through  the  groove  in  the  styloid  side  of  the  radius,  along 
with  the  last-named  muscle. 

It  is  inserted  into  the  first  phalanx  of  the  thumb,  by  its  tendon, 
which  is  extended  to  the  root  of  the  second  phalanx. 

It  extends  the  first  phalanx.2 

9.  The  Extensor  Major,  or  Secundi  Internodii  Pollicis  Manus, 

Arises,  by  a  small  tendinous,  and  an  extensive  fleshy  origin,  from 
the  back  of  the  ulna  above  its  middle,  and  from  the  interosseous  liga- 
ment, also  from  the  back  of  the  radius  ;  it  terminates  near  the  wrist  in 
a  tendon  which  passes  through  the  groove  on  the  back  of  the  radius 
near  the  ulna.  The  belly  of  this  muscle  conceals,  very  much,  the 
other  extensors  of  the  thumb. 

It  is  inserted,  by  its  tendon,  into  the  oblong  transverse  tubercle,  on 
the  back  of  the  base  of  the  second  phalanx  of  the  thumb.  Its  tendon 
is  furnished  with  one  synovial  sheath,  at  the  inferior  extremity  of  the 
radius,  which  extends  to  the  carpus ;  and  another  which  is  smaller, 
and  is  placed  upon  the  carpus  and  upon  the  base  of  the  first  metacar- 
pal bone. 

It  extends  the  second  phalanx.3 

The  tendons  of  the  last  two  muscles  are  much  connected  with  each 
other,  and  are  spread  in  the  form  of  a  membrane  on  the  back  of  the 
thumb,  after  the  manner  of  the  extensor  tendons  of  the  fingers.  The 
minor  is  generally  a  much  smaller  muscle  than  the  major. 

10.   The  Indicator 

Is  a  small  muscle  on  the  back  of  the  ulna,  concealed  by  the  exten- 
sor communis  and  extensor  ulnaris.  It  arises  tendinous  and  fleshy, 
from  the  back  of  the  ulna,  commencing  near  its  middle,  and  from  the 
contiguous  part  of  the  interosseous  ligament.  It  terminates  in  a  ten- 
don which  goes  through  the  same  fossa  with  the  extensor  communis ; 

1  Varieties.     This  muscle  is  sometimes  double,  and  has  several  other  modifications  which 
it  is  unnecessary  to  state. 

2  Varieties.     This  muscle  is  sometimes  only  an  appendage  of  the  preceding.     Occa- 
sionally, its  tendon  is  confounded  with  that  of  the  succeeding  muscle. 

3  Varieties.     Sometimes  this  muscle  is  completely  double. 


MUSCLES  OF  THE  HAND.  427 

it  afterwards  is  joined  about  the  base  of  the  first  phalanx  to  the  ten- 
don of  the  common  extensor  belonging  to  the  fore  finger. 

With  the  tendon  of  the  extensor  coinmunis,  it  is  inserted  along  the 
back  of  the  fore  finger  as  far  as  the  base  of  the  third  phalanx. 

It  extends  the  fore  finger.1 


SECT.  V. — OF  THE  MUSCLES  OF  THE  HAND. 

The  Palmar  is  Brevis 

Is  just  below  the  skin,  at  the  inner  side  of  the  palm  of  the  hand. 
It  consists  of  separate  fasciculi  unequally  divided,  and  arises  from  the 
anterior  ligament  of  the  wrist,  and  from  the  ulnar  side  of  the  palmar 
aponeurosis. 

It  is  inserted  into  the  skin  and  fat  at  the  inner  margin  of  the  hand, 
and  covers  the  muscles  of  the  little  finger. 

It  contracts  the  skin  of  the  hand. 

Beneath  the  Aponeurosis  Palmaris  are  placed  the  long  flexor  ten- 
dons, and  many  of  the  small  muscles  of  the  hand. 

The  Lumbricales 

Are  conspicuous  ;  they  are  four  in  number,  of  the  size  and  shape  of 
earth  worms.  They  arise,  tendinous  and  fleshy,  from  the  radial  sides 
of  the  tendons  of  the  flexor  profundus,  beneath  the  ligainentum  carpi 
annulare  anterius,  and  a  little  beyond  its  inferior  edge. 

They  terminate  in  little  flat  tendons,  which  run  along  the  outer  or 
radial  edge  of  the  fingers,  and  are  inserted  respectively  into  the  tendi- 
nous expansion  of  the  extensor  communis  on  the  back  of  the  first  pha- 
lanx of  each  finger,  about  its  middle. 

They  bend  the  first  phalanges.2 

Four  muscles  constitute  the  ball  of  the  thumb. 

1.   The  Abductor  Pollicis  Manus 

Arises,  tendinous  and  fleshy,  from  the  anterior  surface  of  the  ante- 
rior carpal  ligament,  and  from  the  projecting  ends  of  the  trapezium 
and  scaphoides. 

It  is  inserted,  tendinous,  into  the  outer  side  of  the  base  of  the  first 
phalanx  of  the  thumb,  and  into  the  tendinous  membrane  derived  from 
the  extensors  on  its  back  part. 

1  Varieties.      This  muscle  is  subject  to  many  modifications ;  sometimes  it  is  digastric; 
sometimes  it  is  double,  and  the  second  head  goes  to  the  middle  finger.    In  the  latter  case 
anatomists  have   recognized  a  disposition  similar  to  that  of  the  short  extensors  of  the  toes, 
and  also  an  arrangement  corresponding  with   what  occurs  in  some  species  of  the  ape. 
Another  example  of  the  truth  of  the  rule  that  the  most  of  those  varieties  in  the  muscular  sys- 
tem, commonly  called  anomalies,  are  only  indications  on  the  part  of  nature  of  the  alliance 
between  the  structure  of  man  and  that  of  the  lower  orders  of  animals.     In  which  point  of 
view,  they  are  both  instructive  and  amusing,  and  are  well  deserving  of  attention. 

2  Varieties.     Sometimes  one  is  deficient;  sometimes  one  or  more  is  double,  in  which  case 
the  supernumerary  goes  to  the  ulnar  edge  of  the  adjoining  finger. 


428 


The  Muscles  of  the  Hand.  1.  The  annular  ligament.  2,  2.  The  origin  and  insertion  of  the  abciuc- 
torpollicis  muscle;  the  middle  portion  has  been  removed.  3.  The  flexor  ossis  metacarpi,  or  oppo- 
neus  pollicis.  4.  One  portion  of  the  flexor  brevis  pollicis.  5.  The  deep  portion  of  the  flexor  brevis 
pollicis.  6.  The  adductor  pollicis.  7,7.  The  lumbricales  muscles,  arising  from  the  deep  flexor  ten- 
dons, upon  which  the  numbers  are  placed.  The  tendons  of  the  flexor  sublimis  have  been  removed 
from  the  palm  of  the  hand.  8.  One  of  the  tendons  of  the  deep  flexor,  passing  between  the  two  termi- 
nal slips  of  the  tendon  of  the  flexor  sublimis,  to  reach  the  last  phalanx.  9.  The  tendon  of  the  flexor 
longus  pollicis,  passing  between  the  two  portions  of  the  flexor  brevis  to  the  last  phalanx.  10.  The  ab- 
ductor minimi  digiti.  11.  The  flexor  brevis  minimi  digiti.  '!  he  edge  of  the  flexor  ossis  metacarpi,  or 
adductor  minimi  digiti,  is  seen  projecting  beyond  the  inner  border  of  the  flexor  brevis.  12.  The  pro- 
minence of  the  pisiform  bone.  13.  The  first  dorsal  interosseous  muscle,  or  the  abductor  indicis. 


It  draws  the  thumb  from  the  fore  finger, 
skin. 


This  muscle  is  next  to  the 


2.   The  Opponens  Pollicis 

Is  beneath  the  abductor,  andwithout  its  removal  can  scarcely  be  seen. 
It  arises,  tendinous  and  fleshy,  from  the  projecting  point  of  the  os  tra- 
pezium, and  from  the  adjacent  part  of  the  anterior  carpal  ligament. 

It  is  inserted,  tendinous  and  fleshy,  into  the  radial  edge  of  the  meta- 
carpal  bone  of  the  thumb,  from  its  base  to  its  head. 

It  draws  the  metacarpal  bone  inwards. 


3.    The  Flexor  Brevis  Pollicis  Manus 

Is  beneath  the  abductor  pollicis,  and  at  the  side  of  the  opponens  pol- 
licis. A  groove  is  formed  in  it  by  the  tendon  of  the  flexor  longus  pol- 
licis, which  divides  it  into  two  heads. 

The  first  head  arises,  fleshy,  from  the  point  of  the  trapezium,  trape- 
zoides,  and  from  the  contiguous  part  of  the  internal  surface  of  the  ante- 
rior annular  ligament,  and  is  inserted  into  the  outer  sesamoid  bone;  the 
sesamoid  bone,  like  a  patella,  being  connected  to  the  first  phalanx  of 
the  thumb  by  a  tendon. 

The  second  or  internal  head  arises,  fleshy,  from  the  magnum  and 
unciforme,  near  their  metacarpal  surfaces,  and  from  the  base  of  the 


MUSCLES  OF  THE  HAND.  429 

metacarpal  bone  of  the  middle  finger.  It  is  inserted  into  the  inner 
sesamoid  bone,  "which,  like  the  external,  is  connected  by  ligament  to 
the  first  phalanx. 

The  short  flexor,  as  its  name  implies,  bends  the  first  phalanx  of  the 
thumb. 

4.   The  Adductor  Pollicis  Manus 

Lies  in  the  palm  of  the  hand,  beneath  the  lumbricales  and  the  tendons 
of  the  flexor  sublimis  and  profundus.  It  arises,  fleshy,  from  the  ulnar 
edge  of  the  metacarpal  bone  of  the  middle  finger,  between  its  base  and 
head,  and  it  is  inserted,  tendinous,  into  the  inner  part  of  the  base  of 
the  first  phalanx  of  the  thumb,  just  beyond  the  sesamoid  bone. 

It  pulls  the  thumb  towards  the  fingers. 

The  Abductor  Indicis  Manus 

Is  on  the  radial  edge  of  the  hand,  between  the  metacarpal  bone  of 
the  fore-finger  and  thumb,  and  is  just  beneath  the  skin.  It  arises  ten- 
dinous from  the  trapezium,  and  fleshy  from  the  ulnar  edge  of  the  meta- 
carpal bone  of  the  thumb,  between  its  base  and  head. 

Being  placed  along  the  side  of  the  metacarpal  bone  of  the  fore  finger, 
it  is  inserted,  by  a  short  tendon,  into  the  radial  side  of  the  first  pha- 
lanx, in  company  with  the  prior  indicis.  This  muscle,  in,  connection 
with  the  prior  indicis,  is  the  first  dorsal  interosseal  of  some  writers. 

It  draws  the  fore  finger  from  the  others. 

There  are  three  muscles  constituting  the  ball  of  the  ulnar  side  of  the 
hand,  or  of  the  little  finger. 

1.   The  Abductor  Minimi  Digiti  Manus 

Is  the  most  superficial.  It  arises,  fleshy,  from  the  protuberance  on 
the  internal  side  of  the  os  pisiforme,  and  from  the  contiguous  part  of 
the  annular  ligament. 

It  is  inserted,  tendinous,  into  the  ulnar  side  of  the  first  phalanx  of 
the  little  finger,  and  into  the  tendinous  membrane  which  covers  its  back 
part. 

It  draws  the  little  finger  from  the  rest. 

2.   The  Flexor  Parvus  Minimi  Digiti  Manus 

Is  beneath  the  abductor.  It  arises,  fleshy,  from  the  unciform  process 
of  the  os  unciforme_,  and  from  the  contiguous  part  of  the  anterior  annular 
ligament. 

It  is  inserted,  tendinous,  into  the  ulnar  side  of  the  base  of  the  first 
phalanx  of  the  little  finger,  being  united  with  the  tendon  of  the  abductor, 
and  with  the  tendinous  membrane  expanded  over  the  back  of  the  finger. 

It  bends  the  little  finger.1 

1  Varieties.  Sometimes  it  is  wanting,  in  which  case  the  preceding  is  more  developed  than 
usual. 


430  MUSCLES. 

3.   The  Adductor  Metaearpi  Minimi  Digiti 

Is  placed  beneath  the  abductor  and  flexor,  next  to  the  metacarpal 
bone.  It  arises,  fleshy,  from  the  unciform  process  of  the  os  unciforme  ; 
and  from  the  contiguous  part  of  the  annular  ligament  of  the  wrist. 

It  is  inserted,  tendinous  and  fleshy,  into  the  fore  part  of  the  meta- 
carpal bone  of  the  little  finger,  from  its  base  to  its  head. 

It  brings  the  metacarpal  bone  of  the  little  finger  towards  the  wrist, 
and  thereby  deepens  the  hollow  of  the  hand. 

The  Interosseous  Muscles  fill  up  the  interstices  of  the  metacarpal 
bones ;  they  are  seven  in  number,  four  on  the  palm,  and  three  on  the 
back  of  the  hand.  The  back  ones  arise  by  double  heads  from  the  con- 
tiguous sides  of  two  metacarpal  bones  ;  the  palmar  ones  have  a  single 
head,  which  comes  only  from  the  metacarpal  bone  of  the  finger,  which 
the  interosseous  muscle  is  intended  to  serve.  As  a  general  description, 
they  all  may  be  said  to  arise,  fleshy  and  tendinous,  from  the  bases 
and  sides  of  the  metacarpal  bones,  and  to  be  inserted,  tendinous,  into 
the  sides  of  the  first  phalanges,  and  into  the  tendinous  membrane  on 
the  backs  of  the  fingers,  derived  from  the  tendons  of  the  extensor  com- 
munis.  The  first  four  must  be  looked  for  on  the  palm,  the  three  others 
on  the  back  of  the  hand. 

1.   The  Prior  Indicis 

Is  along  the  radial  side  of  the  first  digital  metacarpal  bone,  and 
arises  from  the  base  and  side  of  the  same. 

It  is  inserted,  tendinous,  into  the  radial  side  of  the  first  phalanx  of 
the  fore  finger. 

It  draws  the  fore  finger  towards  the  thumb. 

The  abductor  indicis  and  this  muscle  are  very  closely  united  at  their 
insertion.  This  circumstance,  together  with  their  analogy  with  the  first 
dorsal  interosseal  of  the  foot,  has  induced  many  anatomists  to  identify 
them  as  a  common  muscle.  It  simplifies  the  description,  and  has  that  to 
recommend  it;  the  actual  division,  however,  is  so  well  marked,  much  more 
strongly  than  that  in  many  other  muscles  admitted  to  be  absolutely  dis- 
tinct, that  it  may  be  well  doubted,  taking  in  view  this  circumstance,  and 
the  strong  action  of  the  abductor  on  the  fore  finger,  whether  effective 
and  useful  description  is  not  thus  sacrificed  ;  and  whether  it  would  not  be 
better  to  divide  the  first  dorsal  interosseal  of  the  foot,  for  the  sake  of 
the  analogy,  if  it  is  to  be  secured,  than  to  merge  a  certainly  distinct 
muscle  in  mere  classification  and  analogy.  The  hand  is  the  member 
in  precedence  from  its  various  functions,  but  if  it  yield  to  the  foot  in 
this  instance,  there  are  others  also  equally,  if  not  more,  urgent. 

2.   The  Posterior  Indicis 

Is  at  the  ulnar  side  of  the  first  digital  metacarpal  bone.  It  arises 
from  the  base  and  ulnar  side  of  the  same  bone,  and  is  inserted  tendi- 
nous into  the  ulnar  side  of  the  first  phalanx  of  the  fore  finger. 

It  draws  the  fore  finger  towards  the  others. 


MUSCLES  OF  THE  HAND.  431 

3.  The  Prior  Annularis 

Is  at  the  radial  side  of  the  metacarpal  bone  of  the  third  or  ring 
finger.  It  arises  from  the  base  and  radial  side  of  the  said  bone. 

It  is  inserted,  tendinous,  into  the  radial  side  of  the  first  phalanx  of 
the  ring  finger. 

It  draws  that  finger  towards  the  thumb. 

4.   The  Interosseus  Auricularis 

Is  at  the  radial  side  of  the  metacarpal  bone  of  the  little  finger,  and 
arises  from  the  radial  side  and  base  of  said  bone. 

It  is  inserted,  tendinous,  into  the  radial  side  of  the  first  phalanx  of 
the  same  finger. 

It  draws  the  little  finger  towards  the  other. 

By  removing  the  tendons  of  the  extensor  communis  from  the  back  of 
the  hand,  we  see  the  three  posterior  or  double-headed  interosseous 
muscles. 


5.   The  Prior  Medii 

Is  between  the  metacarpal  bone  of  the  fore  and  of  the  middle  finger. 
It  arises  from  the  opposed  roots  and  sides  of  these  bones. 

It  is  inserted,  tendinous,  into  the  radial  side  of  the  first  phalanx  of 
the  middle  finger. 

It  draws  the  middle  finger  towards  the  thumb. 

9 

6.   The  Posterior  Medii 

Is  between  the  metacarpal  bone  of  the  middle  and  of  the  ring  finger. 
It  arises  from  the  opposite  sides  and  roots  of  these  bones. 

It  is  inserted,  tendinous,  into  the  ulnar  side  of  the  first  phalanx  of 
the  middle  finger. 

It  draws  the  middle  towards  the  little  finger. 

7.   The  Posterior  Annularis 

Is  between  the  metacarpal  bones  of  the  ring  and  little  finger.  It 
arises  from  the  opposed  sides  and  roots  of  these  metacarpal  bones. 

It  is  inserted,  tendinous,  into  the  ulnar  side  of  the  first  phalanx  of 
the  ring  finger. 

It  draws  the  ring  towards  the  little  finger. 


432 


MUSCLES. 


CHAPTER  IV. 

OF  THE  FASCIA  AND  MUSCLES  OF  THE  LOWER  EXTREMITIES. 
SECT.  I. — OF  THE  FASCIAE. 

THE  muscles  of  the  lower  extremity,  from  the  pelvis  to  the  foot  in- 
clusively, are  invested  by  a  strong  aponeurotic  membrane,  placed  im- 
mediately beneath  the  skin  or  common  integuments.  Its  external  face 
is  in  contact  with  the  superficial  nerves  and  blood-vessels,  and  the  in- 
ternal face  with  the  muscles.  Though  it  is  absolutely  continuous  from 
one  end  to  the  other,  it  will  be  useful,  for  study,  to  divide  it  into  several 
parts ;  one  covering  the  Hip  ;  another  the  Thigh  ;  another  the  Leg, 
and  the  fourth  covering  the  Foot ;  each  of  them  presents  certain  points 
of  arrangement  which  could  not  be  very  conveniently  introduced  into  a 
general  description. 

The  Fascia  Ischiadica,  or  Fascia  of  the  Hip. — The  aponeurosis  be- 
gins posteriorly,  from  the  upper  part  of  the  gluteus  magnus  muscle,  by 
a  very  gradual  conversion  of  the  cellular  membrane  of  the  part  into 
desmoid  substance;  it  also  begins  in  the  way  of  cellular  substance  from 
the  margin  of  the  sacrum  and  os  coccygis.  The  character  here  is  sel- 
dom entirely  aponeurotic  till  it  gets  on  a  level  with  the  tendon  of  the 
gluteus  magnus,  from  which  emanate  a  great  many  of  its  fibres.  Ex- 
ternally, it  arises  from  the  whole  length  of  the  crista  of  the  ilium,  is 
there  strikingly  aponeurotic,  and  is  closely  adherent  to  the  gluteus 
medius  muscle,  many  of  whose  fibres  arise  from  it.  It  also  arises  from 
the  body  and  rami  of  the  pubes,  and  from  the  tuber  and  ramus  of  the 
ischium.  Its  attachment  at  the  latter  is  not  very  strong,  nor  is  its 
character  so  well  marked.  It  is  there,  in  some  measure,  continuous 
with  the  perineal  fascia.  In  front,  it  adheres  very  closely  to  the  in- 
ferior margin  of  the  tendon  of  the  external  oblique  muscle,  so  as  to  be 
almost  continuous  with  it,  from  the  anterior  superior  spinous  process  of 
the  ilium  to  the  pubes ;  and  is  continued  uninterruptedly  into  the  iliac 
fascia,  so  that  it  covers  the  iliacus  internus  and  psoas  magnus  muscles, 
by  that  extension.  The  division  attached  to  the  pelvis,  and  surrounding 
it,  may  be  called  the  Fascia  Ischiadica,  or  fascia  of  the  Hip. 

The  Fascia  Femoris. — From  these  several  connections  at  the  pelvis, 
the  fascia  descends  in  enveloping  the  muscles  of  the  thigh,  and  then 
forms  other  strong  attachments  about  the  knee,  to  the  condyles  of  the 
os  femoris  and  to  the  head  of  the  tibia.  In  front,  it  adheres  very  closely 
to,  and  is  almost  blended  into  the  common  tendon  of  the  extensor 
muscles ;  it  adheres,  also,  to  the  inferior  margins  of  the  two  vasti,  and 
is  one  and  the  same  with  the  membranous  expansion  (involucrum] 
going  from  them  to  the  head  of  the  tibia,  and  answering  the  purpose  of 
capsular  ligament  to  the  articulation  of  the  knee,  on  each  side  of  the 
patella,  as  far  back  as  the  lateral  li<rn  merits.  Behind,  it  covers  up  the 
fat  in  the  ham,  and  is  continued  into  the  fascia  of  the  leg. 


FASCIA  OF  THIGH.  433 

The  fascia  femoris,  almost  everywhere,  consists  in  a  fibrous  texture, 
which  is  sufficiently  evident,  but  the  fibres  pass  in  very  various  direc- 
tions. At  many  places,  particularly  on  the  internal  side  of  the  thigh, 
there  are  oblique  fibres  spread  upon  a  lamina  which  is  not  fibrous.  On 
the  outside  of  the  thigh,  the  fascia  consists  principally  in  longitudinal 
fibres,  held  together  by  transverse  ones,  and  when  its  interior  surface 
is  examined,  many  oblique  fibres  are  also  found  there.  It  is  very  thick 
and  strong  on  the  outer  face  of  the  thigh,  thinner  behind,  and  still  weaker 
internally,  where  cellular  substance  seems  to  predominate  in  its  compo- 
sition. It  is  pierced  at  several  points  with  small  round  holes  for  the 
passing  of  blood-vessels  and  of  the  cutaneous  nerves. 

From  the  interior  surface  of  the  Fascia  Femoris,  partitions  pass  off, 
which  separate  the  muscles  of  the  thigh  from  each  other,  and  form 
sheaths  for  them.  Some  of  these  processes  are  merely  cellular  sub- 
stance; others  have  a  more  distinct  desmoid  character.  Externally,  as 
it  passes  from  the  gluteus  medius  to  the  groin,  it  separates  into  two 
laminae,  which  receive  between  them  the  tensor  vaginse  femoris,  and 
then  reunite.  The  sartorius  muscle,  in  almost  its  whole  length,  is  also 
enclosed  between  two  laminae.  At  the  origin  of  this  muscle,  the  pos- 
terior lamina  passes  on  to  the  iliacus  internus,  and  psoas  magnus 
muscles,  and  then  to  the  pectineus,  to  become  the  Pectineal  Fascia,  in 
all  of  which  distance  it  is  continuous  with  the  iliac  fascia  of  the  pelvis ; 
but  the  anterior  lamina  of  the  fascia  at  this  place,  being  the  Sartorial 
Fascia,  has  its  upper  margin  continuous  with  Poupart's  ligament ;  and 
this  lamina  terminates  in  a  point  or  angle,  which  is  turned  inward  to 

Fig.  134. 


A  view  of  the  Abdominal  Muscles  and  the  Abdominal  or  Inguinal  Canal.  1.  External  oblique  mus- 
cle of  the  abdomen.  2.  Its  aponeurosis.  3.  Its  tendon  slit  up  and  turned  back  to  show  the  canal.  4. 
Anterior  superior  spinous  process.  5.  Upper  portion  of  Poupart's  ligament.  0.  External  column 
of  the  external  ring.  7.  Internal  column  of  the  external  ring.  8.  Intercrossing  of  the  tendons  of  each 
side.  9  Body  of  the  pubes.  10.  Upper  boundary  of  the  external  abdominal  ring — the  line  points  to 
the  ring.  11,12.  Fascia  transversalis.  13.  Fibres  of  the  internal  oblique  turned  up.  14.  Fibres  of 
the  transversalis  muscle.  15.  Points  to  the  internal  ring,  the  opening  is  enlarged  for  the  demonstra- 
tion. 16.  Sartorius.  17.  Fascia  lata  femoris.  18.  Rectus  femoris.  19.  Adductor  longns.  20.  Penis. 
21.  Fascia  lata  of  the  opposite  thigh.  22.  Point  where  the  saphena  vein  enters  the  femoral.  23.  Fascia 
lata  as  applied  to  the  vessels.  24.  Insertion  of  the  transversalis  muscle  on  the  pubis.  25,  2(5.  Corre- 
spond to  11,  12,  of  the  opposite  side  nml  indicate  the  fiiscia  transversalis.  27.  Poiipari's  ligament 
turned  off  from  the  internal  muscles.  28.  Transvergalis  abdominis.  29.  Internal  oblique.  30.  Rectua 
abdominis. 

VOL.  i.— 28 


434  MUSCLES. 

4 

the  crista  of  the  pubes,  and  ends  by  an  insertion  into  it  immediately 
exterior  to  Gimbernat's  ligament,  and  in  the  same  line  with  it.  This 
point,  from  the  part  which  it  acts  in  femoral  hernia,  has  been  studied 
with  particular  attention,  and  goes  under  the  name  of  Hey's,  or 
the  Femoral  Ligament. 

The  pectineal  fascia  is  placed  behind  the  femoral  vessels,  but  the 
sartorial  fascia  is  before  them.1  The  latter  terminates  on  its  pubic 
side,  in  a  crescentic  or  lunated  edge,  of  one  and  a-half  or  two  inches  in 
length,  the  concavity  of  which  is  towards  the  penis.2  Hey's  ligament 
is  the  superior  extremity  of  the  crescent ;  the  inferior  end  can  scarcely 
be  considered  to  have  a  definite  boundary,  but  is  continuous  with  the 
adjacent  part  of  the  pectineal  fascia.  The  place  of  continuity  is 
covered  by  the  saphena  vein,  which  being  between  the  skin  and  the 
fascia  lata,  dips  there  into  the  femoral  vein,  which  is  under  the  cres- 
centic edge.  The  femoral  vessels  reposing  in  their  sheaths,  are  then 
placed  between  these  laminae  of  the  fascia  femoris.  The  vein  is  only 
partially  covered  by  the  lunated  edge,  while  the  artery,  which  is  on 
the  iliac  side  of  the  vein,  is  completely  concealed.  By  keeping  the 
leg  extended,  and  turning  the  toes  of  the  subject  inwards  or  outwards, 
it  will  be  seen  that  the  crescentic  edge  and  the  tendon  of  the  external 
oblique  exercise  a  mutual  tension.  Beneath  Poupart's  ligament,  at 
the  inner  margin  of  the  femoral  vein,  is  the  hole  called  the  Femoral 
Ring,  through  which  the  bowel  escapes  in  femoral  hernia.  This  hole 
is  constricted  by  turning  the  toes  outwards,  and  relaxed  by  turning 
them  inwards;  it  becomes  very  much  relaxed,  if,  at  the  same  time,  the 
thigh  be  drawn  upwards.  Valuable  indications  for  the  mode  of  re- 
placing a  prolapsed  bowel  are  thus  obtained. 

In  addition  to  this  arrangement,  which  is  all-important  in  hernia, 
the  fascia  femoris  has  the  following.  On  the  front  of  the  thigh  it 
simply  covers  the  extensor  muscles,  the  partitions  between  which  are 
areolar  substance.  On  the  inner  side  it  dips  down  to  the  periosteum 
between  the  adductor  muscles,  but  is  still  cellular.  Behind,  it  covers 
the  ham-string  muscles,  and  sends  down  to  the  linea  aspera  a  thick 
fibrous  partition  between  the  vastus  externus  and  the  biceps  flexor. 

The  superior  margin  of  the  gluteus  magnus  is  inserted  into  this 
fascia,  which  from  its  connection  with  the  gluteus  medius  and  tensor 
vaginae  femoris,  causes  all  these  muscles  to  exercise  a  mutual  influence, 
as  well  as  to  keep  tense  the  fascia  itself.  On  the  internal  semi-circum- 
ference of  the  thigh  it  adheres  somewhat  closely  to  the  muscles;  but 
on  the  external,  where  the  fascia  is  opposed  to  the  tendinous  facing  of 
the  vastus  externus  muscle,  it  is  connected  by  a  long,  loose,  and  scat- 
tered cellular  substance,  which  scarcely  presents  an  obstacle  to  the 
introduction  of  the  finger  or  any  blunt  instrument,  between  the  two. 

The  Fascia  Cruralis,  or  that  of  the  Leg,  though  absolutely  con- 
tinuous with  that  of  the  thigh,  may  be  described  as  arising  externally 

1  By  sartorial  fascia  is  merely  meant  the  portion  of  the  fascia   lata  femoris  contiguous  to 
the  sartorius  muscle;  and,  by  pectineal  fascia,  the  part  covering  the  pectineus  muscle. 

2  The  crescentic  edge  is  not  always  well  defined,  for  in  many  cases  it  is  blended  insensi- 
bly with  the  sheath  of  the  blood-vessels,  so  that  a  defined  exhibition  of  it  is  rather  the 
result  of  artificial  separation  or  dissection,  than  a  natural  condition. 


FASCIA  OF  FOOT. 


435 


from  the  head  of  the  fibula  and  from  a  prolongation  of  the  biceps 
flexor  cruris ;  internally  from  prolongations  of  the  tendon  of  the  sar- 
torius,  the  gracilis,  and  the  semi-tendinosus.  It,  in  descending,  covers 
all  the  superficial  muscles  of  the  leg,  does  not  go  over  the  tibia,  but 
adheres  to  its  spine  and  to  its  internal  angle.  It  unites  below  to  the 
annular  ligament  of  the  ankle,  to  the  ligamentous  sheath  of  the  pero- 
neal  muscles,  and  to  that  on  the  inner  ankle. 

The  fascia  cruralis,  in  the  superior  half  of  the  leg,  assists  in  giving 
origin  to  its  muscles  inTront  and  externally,  but  is  rather  loosely  at- 
tached to  them  below.  On  the  back  of  the  leg  it  is  also  rather  loosely 
connected  to  the  gastrocnemii.  It  sends  in  one  aponeurotic  partition 
between  the  common  extensor  of  the  toes  and  the  long  peroneus,  and 
another  between  the  latter  and  the  soleus,  both  of  which  are  inserted 
into  the  fibula.  It  also  is  insinuated  between  the  soleus  and  the  mus- 
cles next  to  the  bones.  This  prolongation  is  strong  and  fibrous,  pene- 
trates between  these  muscles,  dips  down  to  the  tibia  and  fibula,  and  is 
lost  insensibly  just  below  the  fascia  of  the  popliteus  muscle.  The  pop- 
liteal fascia  may  also  be  considered  one  of  the  emanations  from  the 
fascia  cruralis. 

The  fascia  cruralis  is  not  so  strong  as  the  femoral,  yet  it  has  the 
same  compact  desmoid  texture,  and  is  formed  from  fibres  crossing  in 
various  directions.  It  is  thicker  in  front  than  behind,  and  is  made 
tense  by  its  connection  with  the  internal  and  external  ham-string 
muscles. 

Of  the  Ligamentum  Annulare  of  the  Ankle  Joint. 

The  muscles  on  the  front  of  the  leg  have  their  tendons  confined  at 
the  ankle  by  this  ligament,  which  may  be  very  properly  associated  with 
the  description  of  the  crural  fascia,  owing  to  the  closeness  of  the  con- 
nection of  the  two.  It  consists  in  a  fasciculus  of  ligamentous  fibres 
running  across  the  front  of  the  ankle  joint.  It  is  attached  by  one  ex- 
tremity to  the  superior  face  of  the  greater  apophysis  of  the  os  calcis, 
just  before  the  malleolus  externus;  is  there  very  strikingly  fibrous  or 
ligamentous,  and  has  its  small  fasciculi  separated  by  fatty  matter.  It 
is  then  directed  inwards,  and  divides  into  two  laminae,  one  of  which 
goes  above  the  tendons,  and  the  other  below  them.  These  laminae,  by 
keeping  to  their  respective  sides  of  the  tendons,  form  a  loose  gutter  for 
each  of  them  to  play  in;  the  gutters,  however,  for  the  tibialis  anticus 
and  extensor  proprius  pollicis  are  not  so  perfect  as  that  for  the  extensor 
communis,  being,  in  fact,  largely  defective  in  front,  and  they  are  also 
more  loose.  The  ligament  is  then  fixed  by  one  division,  the  upper,  to 
the  anterior  margin  of  the  malleolus  internus  :  this  division  goes  behind 
the  tendon  of  the  extensor  proprius  pollicis  and  that  of  the  tibialis  an- 
ticus. The  other  portion  being  in  front  of  them  and  nearer  to  the  foot, 
is  wrapped  over  its  internal  face  and  inserted  into  the  scaphoides  and 
the  internal  margin  of  the  fascia  plantaris.  As  the  upper  margin  of 
this  ligament  is  continuous  with  the  fascia  cruralis,  so  the  inferior  runs 
into  the  fascia  on  the  back  of  the  foot,  called  Aponeurosis  Dorsalis 
Pedis. 


436  MUSCLES. 

I 

Fascia  Pedis,  or  Aponeurosis  of  the  Foot. — The  fascia  cruralis  being 
strongly  attached  to  the  posterior  and  lower  margins  of  the  internal 
ankle,  its  fibres  radiate  thence  to  the  lower  part  of  the  tendo-Achillis,  to 
the  inner  side  of  the  os  calcis,  and  to  the  internal  margin  of  the  fascia 
plantaris.  This  is  the  Ligamentum  Laciniatum  (or  plaited  ligament)  of 
writers,  and  conceals  the  tendons  which  pass  to  the  sole  of  the  foot, 
along  the  sinuosity  of  the  os  calcis. 

The  Aponeurosis  Dorsalis  Pedis  is  continued  from  the  annular  liga- 
ment, over  the  upper  surface  of  the  foot,  to  the  roots  of  the  toes.  It 
is  thin,  but  its  fibrous  texture  is  apparent.  It  is  spread  over  the  exten- 
sor tendons  of  the  toes  and  the  extensor  brevis  muscle,  and  is  slightly 
attached  along  the  internal  and  the  external  margin  of  the  foot. 

The  Aponeurosis  Plantaris  is  on  the  sole  of  the  foot,  between  its 
common  integuments  and  the  muscles.  It  is  attached  behind  to  the 
tuberosities  of  the  os  calcis,  and  is  quickly  divided  into  three  portions, 
which  are  kept  distinct  by  well-marked  depressions  between  them. 
The  internal  portion  lies  upon  the  muscles  at  the  inner  side  of  the  foot, 
the  external  portion  upon  the  muscles  at  the  outer  side,  and  the  middle 
covers  longitudinally  the  central  parts  of  the  sole.  The  first  two  por- 
tions are  thin,  reticulated,  and  extended  respectively  to  the  root  of  the 
outer  and  of  the  inner  metatarsal  bone,  and  along  the  margin  of  the 
foot,  where  they  join  the  fascia  or  aponeurosis  dorsalis.  The  middle 
portion  increases  in  breadth  as  it  advances,  and  at  the  anterior  ex- 
tremity of  the  metatarsus  is  divided  into  five  slips,  one  for  each  meta- 
tarsal bone.  The  lumbricales,  the  vessels,  and  the  nerves,  pass  to  their 
toes,  respectively,  between  these  primary  divisions.  Each  of  these  slips 
is  subdivided  into  two,  which  penetrate  upwards,  and  fix  themselves  to 
their  respective  side  of  the  head  of  the  corresponding  metatarsal  bone. 
In  the  interval  left  by  this  bifurcation,  the  flexor  tendons  pass  to 
the  toe. 

The  plantar  aponeurosis  or  fascia  affords  behind  origin  to  the  super- 
ficial muscles  of  the  sole  of  the  foot.  It  also  sends  in  partitions  between 
them.  Its  thickness  is  considerable  behind,  but  continually  diminishes 
as  it  advances  forwards.  Its  fibrous  texture  is  very  well  marked,  and 
is  much  more  compact  near  the  heel,  where  it  looks  like  ligament ;  the 
fibres  run  principally  longitudinally.  From  its  inferior  surface  many 
strong  filaments  pass  to  the  skin  on  the  sole  of  the  foot,  and  contain 
within  their  interstices  a  granulated  adeps. 

The  adipose  matter  is  nearly  half  an  inch  thick  on  the  heel;  it  cruises 
thence  along  the  outer  margin  of  the  foot,  as  a  thinner  layer,  and  is 
again  increased  in  thickness  along  the  anterior  ends  of  the  metatarsal 
bones,  being  mixed  up  with  the  bifurcations  and  with  the  reticular  ar- 
rangements there,  of  the  plantar  aponeurosis.  On  the  hollow  of  the 
foot,  as  on  that  of  the  hand,  the  thickness  of  the  cushion  of  fat  is  much 
reduced,  the  fascia  plantaris  being  very  near  the  skin. 


MUSCLES  OF  THE  THIGH. 


437 


SECT.  II. — MUSCLES  OF  THE  THIGH. 

The  Tensor  Fasciae,  vel  Vaginae  Femoris, 

Is  situated  superficially  on  the  anterior  outer  part  of  the  hip.  It 
arises,  tendinous,  from  the  anterior  superior  spinous  process  of  the 
ilium;  passes  downwards  and  somewhat  backwards  between  two  laminae 
of  the  fascia  femoris,  increasing  in  breadth  as  it  descends,  and  is  in- 
serted fleshy  into  the  fascia  femoris,  somewhat  below  the  level  of  the 
trochanter  major. 

It  rotates  the  foot  inwards,  and  makes  the  fascia  tense. 


The  Sartorius 

Is  placed  superficially  on  the  internal  side  of  the  thigh.  It  arises 
by  a  short  tendon  from  the  anterior  superior  spinous  process  of  the 
ilium,  and  passes  in  a  spiral  course  to  the  inner  side  of  the  thigh  and 
to  the  back  of  the  internal  condyle.  It  then  winds  behind  the  head  of 
the  tibia,  and  advances  forwards,  so  as  to  be  inserted  into  the  internal 

Fig.  135. 


A  view  of  the  Muscles  on  the  Front  of  the  Thigh.  1.  Crest  of  the  ilium.  2.  Its  anterior  superior  spi- 
nous process.  3.  Gluteus  medius.  4.  Tensor  vajrinse  femoris.  5.  Sartorius.  6.  Rectus  femoris.  7. 
Vastus  externus.  8.  Vastus  internus.  9.  Patella.  10.  Iliaeus  interims.  11.  Psoas  magnus.  12. 
Pectiueua.  13.  Adductor  longua.  14.  Adductor  magnus.  15.  Gracilis. 


438  MUSCLES. 

side  of  the  lower  part  of  its  tubercle,  by  a  broad  tendon.  Its  fibres 
run  the  whole  length  of  the  muscle. 

Its  tendon  is  continued  by  a  flat  slip  from  its  lower  margin,  into  the 
fascia  cruralis,  by  which  attachment  the  muscle  is  held  in  its  spiral 
course.  It  crosses  the  rectus  femoris  and  vastus  internus,  above  the 
triceps  adductor,  at  the  middle  of  the  thigh  ;  and  at  the  lower  part  of 
the  latter,  just  above  the  knee,  it  is  between  the  tendon  of  the  adductor 
magnus  and  that  of  the  gracilis. 

It  bends  the  leg  and  draws  it  obliquely  inwards.1 

The  Rectus  Femoris 

Is  in  front  of  the  thigh  bone  and  just  beneath  the  fascia  femoris,  writh 
the  exception  of  its  origin,  which  is  covered  by  the  sartorius.  It  is  a 
complete  penniform  muscle,  fleshy  in  front,  for  the  most  part,  but  faced 
behind  with  tendon.  It  arises  from  the  anterior  inferior  spinous  pro- 
cess of  the  ilium,  by  a  round  tendon,  which  is  joined  by  another  tendon, 
coming  from  the  superior  margin  of  the  acetabulum. 

It  is  inserted  into  the  superior  surface  of  the  patella  by  a  strong 
tendon,  and  intermediately,  by  the  ligamentum  patellae,  into  the  tubercle 
of  the  tibia. 

It  extends  the  leg. 

The  Vastus  Externus 

Is  a  very  large  muscle  on  the  outside  of  the  thigh ;  it  arises,  tendi- 
nous and  fleshy,  from  the  upper  part  of  the  os  femoris,  immediately 
below  the  trochanter  major.  Its  origin  commences  in  front,  and  passes 
obliquely  around  the  bone  to  the  linea  aspera.  It  continues  afterwards 
to  arise  from  the  whole  length  of  the  linea  aspera,  and  from  the  upper 
half  of  the  line  running  from  it  to  the  external  condyle. 

Its  fibres  pass  inwards  and  downwards,  and  are  inserted,  by  a  flat 
tendon,  into  the  external  edge  of  the  tendon  of  the  rectus,  and  also  into 
the  external  upper  part  of  the  patella.  This  muscle  has  a  broad  ten- 
dinous surface  exteriorly  and  above ;  at  its  lower  part  it  has  a  tendi- 
nous facing  on  the  side  next  to  the  bone. 

It  also  extends  the  leg. 

The  Vastus  Internus 

Covers  the  whole  inside  of  the  os  femoris.  It  begins  by  a  pointed 
fleshy  origin,  in  front  of  the  os  femoris,  just  on  a  level  with  the  tro- 
chanter minor ;  and  then  continues  to  arise  tendinous  and  fleshy  from 
the  whole  length  of  the  internal  edge  of  the  linea  aspera,  and  from  the 
line  leading  from  it  to  the  internal  condyle. 

Its  fibres  descend  obliquely,  and  are  inserted,  by  a  flat  tendon,  into 

1  Varieties.  Sometimes  a  small  fasciculus  is  detached  from  its  inferior  part  ;  sometimes 
its  fibres  are  interrupted  by  a  middle  tendon  which  adheres  closely  to  the  fascia  femoris. 
Meekel  reports  it  as  deficient  in  one  case  that  he  met  with.  In  the  African  I  have  occa- 
sionally seen  it  almost  doubly  broad. 


MUSCLES  OF  THE  THIGH.  439 

the  internal  edge  of  the  tendon  of  the  rectus,  and  into  the  upper  in- 
ternal edge  of  the  patella. 
It  also  extends  the  leg. 

The  Crurssus 

Is  almost  completely  overlapped  and  concealed  by  the  two  vasti,  and 
is  immediately  behind  the  rectus  femoris.  The  edge  of  the  vastus  ex- 
ternus,  above,  is  very  distinguishable  from  it,  as  it  overlaps  it,  and  is 
rounded  off,  besides  being  somewhat  separated  by  vessels.  But  the  origin 
of  the  vastus  internus  is  not  so  distinguishable,  as  the  two  muscles  run 
into  each  other ;  it  is,  therefore,  necessary,  most  frequently,  to  cut 
through  some  of  their  fibres  on  the  internal  face  of  the  os  femoris,  on 
a  level  with  the  trochanter  minor.  The  crurseus  will  be  then  seen  to 
arise,  fleshy,  from  all  the  fore  part  of  the  bone,  and  from  all  its  outside 
as  far  as  the  linea  aspera.  Between  the  internal  edge  of  this  muscle 
and  the  linea  aspera,  the  interior  face  of  the  os  femoris  is  free  or  un- 
occupied, for  the  breadth  of  an  inch  along  the  whole  shaft  of  the  bone, 
which  is  very  readily  seen  by  turning  off  the  vastus  internus. 

The  crurseus  is  inserted  into  the  posterior  face  of  the  tendon  of  the 
rectus  below,  and  into  the  upper  surface  of  the  patella. 

It  also  extends  the  leg. 

A  small  fasciculus  at  the  lower  part  of  this  muscle,  which  is  inserted 
into  the  synovial  membrane  of  the  knee  joint,  is  called  the  Sub-cruraeus.1 

The  Ligamentum  Patellae  is  the  common  cord  by  which  the  action  of 
the  last  four  named  muscles  is  communicated  to  the  tibia.  It  is  a  flat- 
tened thick  tendon,  an  inch  and  a  half  wide,  arising  from  the  inferior 
edge  of  the  patella,  and  inserted  into  the  tubercle  of  the  tibia.  Between 
its  insertion  and  the  head  of  the  tibia,  is  a  bursa.  Besides  this,  a  fascia 
or  tendinous  expansion  (involucrum),  an  appurtenance  of  the  fascia 
femoris,  as  mentioned  before,  comes  from  the  inferior  ends  of  these 
muscles,  extends  itself  over  the  whole  of  the  anterior  and  lateral  parts 
of  the  knee  joint,  and  is  inserted  into  the  head  of  the  tibia  and  of  the 
fibula.  Through  this  it  happens  that,  even  when  the  patella  or  its 
tendon  is  ruptured,  some  motion  or  extension  may  be  communicated  to 
the  leg  from  the  thigh. 

In  consequence  of  the  common  insertion  of  these  four  muscles,  some 
anatomists  describe  them  as  but  one,  under  the  name  of  Quadriceps 
Femoris.2 

A  bursa  exists  between  the  lower  part  of  their  tendon  and  the  fascia 
femoris,  higher  up  than  the  patella;  occasionally,  one  is  found  still 
lower  down,  on  the  patella.3 

The  Grracilis 

Is  a  beautiful  muscle  at  the  inner  margin  of  the  thigh,  and  lies  imme- 
diately under  the  fascia ;  it  extends  from  the  pelvis  to  the  leg. 

1  Wilson's  Anat,p.  229. 

2  Scemmering  de  Corp.  Human.  Fabr. 

3  Some  unimportant  varieties  have  been  observed  in  these  extensor  muscles. 


440 


MUSCLES. 


It  arises,  by  a  broad  thin  tendon,  from  the  front  of  the  os  pubis,  just 
at  the  lower  part  of  its  symphysis,  and  from  its  descending  ramus;  the 
muscle  tapers  to  a  point  below,  and  a  little  above  the  knee,  terminates 
in  a  round  tendon,  which  passes  behind  the  internal  condyle  of  the  os 
femoris  and  the  head  of  the  tibia.  It  then  makes  a  curve  forwards  and 
downwards  at  the  internal  side  of  the  latter,  and  is  inserted  at  the  lateral 
and  inferior  part  of  its  tubercle,  just  above  the  insertion  of  the  semi- 
tendinosus. 

The  tendon  at  the  knee  is  beneath  the  tendon  of  the  sartorius.  This 
muscle  is  a  flexor  of  the  leg. 

Fig.  136. 


A  view  of  the  Deep-seated  Muscles  on  the  Front  of  the  Thigh. — 1.  Os  ilium.  2.  Capsular  liga- 
ment of  the  hip-joint.  3.  Trochanter  major.  4.  Origin  of  the  pectineus  muscle.  5.  Symphysis  Pubis. 
6.  Origin  of  the  adductor  longus.  7.  Insertion  of  the  iliacus  internus  and  psoas  magnus.  8.  Insertion 
of  the  pectineus.  9.  Middle  of  the  adductor  longus.  10.  Tendinous  insertion  of  the  adductor  longus. 
11.  Part  of  the  adductor  brevis  seen  between  the  pectineus  and  adductor  longus.  12.  Cut  edge  of  the 
vastus  internus.  13.  Aperture  for  the  passage  of  blood-vessels.  14.  Opening  for  the  femoral 
vessels  15.  Portion  of  the  crurseus.  16.  A  common  defect  in  tendon  of  adductor  magnus  17.  Cut 
tendon  of  the  quadriceps  femoris.  18.  Internal  portion  of  the  knee-joint.  19.  Tendon  of  the  patella. 


The  Pectinalis,  or  Pectineus, 

Is  a  short,  fleshy  muscle,  at  the  inner  edge  of  the  psoas  magnus.  It 
arises,  fleshy,  from  the  concavity  on  the  upper  face  of  the  pubes,  be- 
tween the  Knea  innominata,  and  the  ridge  above  the  obturator  foramen, 
and  is  inserted,  tendinous,  into  the  linea  aspera,  immediately  below  the 
trochanter  minor. 


MUSCLES  OF  THE  THIGH.  441 

It  draws  the  thigh  inwards  and  forwards.1 

The  Adductors. 

The  Triceps  Adductor  Femoris  is  a  large  muscular  mass,  consisting 
in  three  distinct  portions,  placed  at  the  inner  side  of  the  thigh,  and  con- 
tributing largely  to  fill  the  space  between  the  thigh  bones  above.  These 
portions  are  as  follows: 

1.  The  Adductor  Longus,  which  comes,  by  a  rounded  short  tendon, 
from  the  upper  front  part  of  the  pubes  near  its  symphysis ;  it  forms  a 
triangular  belly,  which  increases  in  breadth  in  its  descent,  and  is  inserted 
into  the  middle  third  of  the  linea  aspera  at  its  inner  edge. 

As  the  subject  lies  on  its  back,  this  muscle  is  uppermost;  its  origin 
is  between  that  of  the  pectinalis  and  of  the  gracilis ;  its  upper  edge  is 
in  contact  with  the  lower  edge  of  the  pectinalis.2 

2.  The  Adductor  Brevis  is  the  smallest  of  the  three ;  it  is  situated 
beneath  the  adductor  Ipngus  and  pectinalis,  and  on  the  outside  of  the 
gracilis.     It  arises,  by  a  rounded  tendon,  from  the  middle  front  part  of 
the  pubes,  between  its  symphysis  and  the  foramen  thyroideum,  just 
below  the  origin  of  the  first  adductor. 

It  is  inserted  into  the  upper  third  of  the  inner  edge  of  the  linea 
aspera,  between  the  trochanter  minor  and  the  upper  edge  of  the  ad- 
ductor longus,  by  a  flat  thin  tendon.3 

3.  The  Adductor  Magnus  is  below  the  other  two,  and  is  by  far  the 
largest.     It   arises,  fleshy,  from  the  lower  part   of  the  body   of  the 
pubes  and  from  its  descending  ramus;   also  from  the  ascending  ramus 
of  the   ischium   as  far  as  its  tuberosity,  occupying  the  whole  bony 
surface  between  the  foramen  thyroideum  below,  and  the  margin  of  the 
bone. 

It  is  inserted,  fleshy,  into  the  whole  length  of  the  linea  aspera,  and 
on  its  internal  margin  a  tendon  is  gradually  generated,  which  passes 
downwards,  to  be  inserted  into  the  upper  part  of  the  internal  condyle 
of  the  os  feinoris,  and,  by  a  thin  edge  or  expansion  more  or  less  defect- 
ive, into  the  line  leading  from  the  linea  aspera  to  the  internal  condyle. 

The  adductor  magnus  separates  the  muscles  on  the  anterior  from 
such  as  are  on  the  posterior  part  of  the  thigh ;  and  its  insertion  is 
closely  connected  with  the  origin  of  the  vastus  internus,  the  two  sur- 
faces adhering  by  a  short  and  compact  .cellular  membrane.4 

The  three  adductors  contribute  to  the  same  end,  that  of  drawing  the 
thigh  inwards.  The  pectineus  muscle  is  also  associated  with  them  so 

1  Varieties.    Sometimes  this  muscle  is  split  into  two  by  a  fissure,  in  which  case  the  lower 
portion  is  the  smaller,  and  has  its  tendon  below,  connected  or  joined  to  the  tendon  of  the 
other,  and  its  other  extremity  attached  to  the  upper  internal  margin  of  the  thyroid  foramen. 

2  Varieties.     Occasionally  this  muscle  is  divided  into  two  by  a  fissure,  which  is  of  various 
lengths.     Sometimes  it  is  continued  much   lower  down  by  means  of  a  small  tendon  united 
to  that  of  the  adductor  magnus. 

3  Varieties.     It  is  also  occasionally  split,  more  or  less  fully,  into  two  muscles  by  a  fissure 
which,  according  to  Meckel,  establishes  a  remarkable  analogy  with  apes. 

4  Varieties.     Jt  also  is  occasionally  divided  into  two  portions,  as  in  apes. 


442  MUSCLES. 

closely  in  its  course  and  character,  that,  as  Meckel  has  suggested,  it 
ought  to  be  considered  as  a  fourth  head  to  the  triceps. 

The  G-lutseus  Magnus 

Arises,  fleshy,  from  the  posterior  third  or  fourth  of  the  crista  of  the 
ilium,  and  the  adjoining  flat  surface  of  the  dorsum  of  the  bone  ;  from 
the  side  of  the  sacrum  below  it;  from  the  side  of  the  os  coccygis,  and 
from  the  posterior  surface  of  the  large  sacro-sciatic  ligament.  The 
fibres  of  this  muscle  are  collected  into  large  fasciculi,  with  deep  inter- 
stices between  them  ;  and  the  lower  edge  of  it  is  folded  over  the  poste- 
rior sacro-sciatic  ligament. 

Its  fibres  pass  obliquely  forwards  and  downwards,  and  terminate  in  a 
thick,  broad  tendon,  the  upper  part  of  which  goes  on  the  outside  of 
the  trochanter  major,  and  is  very  strongly  inserted  or  blended  into 
the  fascia  fernoris ;  while  the  lower  part  is  inserted  into  the  upper  third 
of  the  linea  aspera,  going  down  as  far  as  the  origin  of  the  short  head 
of  the  biceps  flexor  cruris. 

This  muscle  is  placed  superficially,  the  fasciculi  being  separated  to 
some  depth  by  processes  from  the  fascia  femoris.  It  covers  nearly 
all  the  other  muscles  on  the  back  part  of  the  pelvis,  laps  over  its  in- 
ferior margin  laterally,  and  conceals  the  origins  of  the  ham-string 
muscles. 

There  is  a  very  large  bursa  placed  between  th^  tendon  of  this  muscle 
and  the  external  face  of  the  trochanter  major  ;  another,  of  almost 
equal  magnitude,  between  it,  the  superior  extremity  of  the  vastus  ex- 
ternus,  and  the  inferior  end  of  the  tensor  fasciae  femoris ;  and  there 
are  two  smaller  ones  between  the  same  tendon  and  the  os  femoris, 
which  are  placed  lower  and  more  posteriorly. 

The  glutseus  magnus  draws  the  thigh  backwards,  and  assists  in  keep- 
ing the  trunk  erect. 

The  G-lutseus  Medius 

Arises  from  the  whole  length  of  the  crista  of  the  ilium,  except  its 
posterior  third,  or  the  part  given  to  the  origin  of  the  magnus ;  from 
the  part  of  the  dorsum  of  the  bone  which  is  between  its  crista  and  the 
semicircular  ridge,  extending  from  the  anterior  superior  spinous  process 
to  the  sciatic  notch ;  from  the  lunated  edge  of  the  os  ilium,  between 
the  anterior  superior  and  the  anterior  inferior  spinous  process ;  and 
largely  from  that  part  of  the  inner  face  of  the  fascia  femoris  which 
covers  this  muscle. 

The  anterior  superior  part  of  this  muscle  is  not  covered  by  the  glutasus 
magnus,  but  lies  before  it.  Its  fibres  converge,  and  are  inserted  by 
a  broad  thick  tendon,  into  the  upper  surface  of  the  trochanter  major, 
and  into  the  upper  anterior  part  of  the  shaft  of  the  bone  just  in  front 
of  this  trochanter. 

It  draws  the  thigh  backwards  and  outwards. 

A  bursa  is  interposed  between  the  extremity  of  its  tendon  and  the 
tendinous  insertions  of  the  small  rotator  muscles. 


MUSCLES  OF  THE  THIGH. 


443 


The  Grlutseus  Minimus 

Arises  from  that  part  of  the  dorsum  of  the  ilium  between  the  semi- 
circular ridge  just  spoken  of,  and  the  margin  of  the  capsular  ligament 
of  the  hip  joint.  It  is  entirely  concealed  by  the  glutaeus  medius. 

Its  fibres  converge  and  terminate  in  a  round  tendon,  which  is  inserted 
into  the  anterior  superior  part  of  the  trochanter  major,  just  within  the 
anterior  insertion  of  the  glutaeus  medius. 

It  abducts  the  thigh,  and  can  also  rotate  the  limb  inwards. 

A  bursa  of  small  size  exists  between  its  tendon  and  the  trochanter 
major. 

Fig.  137. 


A  view  of  the  Deep-seated  Muscles  on  the  Posterior  Part  of  the  Hip  Joint.  1.  Fifth  lumbar  verte- 
bra. "2.  Ilio-lumbar  ligament.  3.  Crest  of  the  ilium.  4.  Anterior  superior  spinous  process.  5. 
Origin  of  the  fascia  femoris.  6.  Gluteus  medius.  7.  Its  lower  and  anterior  portion.  8.  Pyriformis. 
Q.Gemini.  10.  Trochanter  major.  11.  Ridge  between  trochanters.  12.  Quadratus  femoris.  13.  Part 
of  the  adductor  magnus.  14.  Insertion  of  the  gluteus  magnus.  15.  Vastus  externus.  16.  Long 
head  of  the  biceps.  17.  Semi-membranosus.  18.  Semi-tendinosus.  19.  Tuber  ischii.  20.  Obturator 
internus.  21 .  Point  of  the  coccyx.  22.  Posterior  coecygeal  ligament.  23,24.  Greater  sacro-sciatic 
ligament.  25.  Posterior  superior  spinous  process  of  ilium.  26.  Posterior  sacro-iliac  ligaments. 

There  are  several  small  muscles  about  the  hip  joint,  the  most  of 
which  can  be  seen  by  the  removal  of  the  glutaeus  magnus. 


444  MUSCLES. 

The  Pyriformis 

Arises,  fleshy  and  tendinous,  within  the  pelvis,  from  the  anterior  face 
of  the  second,  third,  and  fourth  pieces  of  the  sacrum.  It  forms  a  coni- 
cal belly,  which  passes  out  of  the  pelvis  at  the  upper  part  of  the  sacro- 
sciatic  foramen,  and  receives  a  slip  of  fibres  from  the  posterior  inferior 
spinous  process  of  the  ilium. 

It  is  inserted,  by  a  round  tendon,  into  the  upper  middle  part  of  the 
trochanter  major  within  the  insertion  of  the  glutaeus  medius. 

It  rotates  the  limb  outwards.  Between  its  tendon  and  the  superior 
geminus  a  small  bursa  exists.1 

The  G-emini 

Are  two  small  muscles,  closely  connected  with  each  other,  which  are 
situated  lower  down  on  the  pelvis  than  the  pyriformis.  The  upper  one 
arises  from  the  posterior  part  of  the  root  of  the  spinous  process  of  the 
ischium ;  the  lower  from  the  upper  back  part  of  the  tuberosity  of  the 
ischium. 

Being  parallel  to  each  other,  and  connected  by  their  contiguous  edges, 
they  are  inserted  together  into  the  fossa  trochanterica  upon  the  posterior 
part  of  the  thigh  bone  at  the  root  of  the  trochanter  major. 

They  also  rotate  the  limb  outwards.2 

The  Obturator  Internus 

Is  principally  situated  within  the  cavity  of  the  pelvis.  It  arises, 
fleshy,  from  all  the  margin  of  the  foramen  thyroideum,  except  where 
the  obturator  vessels  go  out ;  from  the  posterior  face  of  the  ligament- 
ous  membrane  stretched  across  it;  also  from  the  upper  part  of  the  plane 
of  the  ischium  just  below  the  linea  innominata.  Its  fibres  converge,  and 
forming  a  tendon,  pass  out  of  the  pelvis  over  the  trochlea  of  the  ischium, 
between  the  sacro-sciatic  ligaments. 

The  tendon  is  placed  between  the  gemini  muscles,  which  form  a 
sheath  for  it;  and  it  is  inserted  into  the  pit  (fossa  trochanterica),  on  the 
back  of  the  os  femoris,  at  the  root  of  the  trochanter  major. 

Between  the  tendon  of  this  muscle  and  the  gemini  is  a  long  bursa ; 
a  second  is  found  where  the  muscle  plays  over  the  ischium. 

It  rotates  the  limb  outwards. 

The  Quadratus  Femoris 

Is  lower  down  than  the  other  muscles.  It  arises,  tendinous  and  fleshy, 
on  the  outer  side  of  the  ischium,  from  the  ridge  which  constitutes  the 
exterior  boundary  of  the  tuberosity.  Its  fibres  are  transverse,  and 
are  inserted,  fleshy,  into  the  rough  ridge  of  the  os  femoris,  on  its  back 
part,  which  goes  from  one  trochanter  to  the  other. 

1  Varieties.     It  is  sometimes  split  by  the  sciatic  nerve,  and  when  the  latter  divides  very 
high  up,  by  one  of  its  portions  only. 

2  Varieties.     The  upper  one  occasionally  does  not  exist,  whereby  a  striking  resemblance 
with  apes  is  established.     Sometimes  both  are  wanting. 


MUSCLES  OF  THE  THIGH.  445 

It  rotates  the  limb  outwards.  A  bursa  exists  between  it  and  the 
trochanter  minor.1  % 

The  Obturator  Externus 

Is  concealed,  in  front,  by  the  pectineus  and  triceps  adductor,  and, 
behind,  by  the  quadratus  femoris  :  to  get  a  satisfactory  view  of  it,  there- 
fore, these  muscles  should  be  detached  from  the  bone.  It  arises  from 
the  whole  anterior  circumference  of  the  foramen  thyroideum,  excepting 
the  place  where  the  obturator  vessels  come  out,  and  from  the  anterior 
face  of  the  ligamentous  membrane  stretched  across  it. 

The  fibres  of  this  muscle  converge,  pass  beneath  the  capsular  liga- 
ment of  the  hip  joint,  in  adhering  to  it,  and  terminate  successively  in  a 
round  tendon,  which  is  inserted  into  the  inferior  part  of  the  cavity  on 
the  posterior  surface  of  the  os  femoris,  at  the  root  of  the  trochanter 
major.  The  course  of  the  tendon  of  this  muscle  is  marked  on  the  neck 
of  the  thigh  bone  by  a  superficial  fossa. 

It  rotates  the  thigh  outwards. 

The  Biceps  Flexor  Oruris 

Constitutes  the  outer  hamstring,  and  is  situated  on  the  posterior 
outer  part  of  the  thigh.  It  arises  by  two  heads.  The  first,  called  the 
long  head,  has  an  origin,  in  common  with  the  semi-tendinosus,  from  the 
upper  back  part  of  the  tuberosity  of  the  ischium,  by  a  short  tendon, 
which,  in  its  descent,  is  changed  into  a  thick  fleshy  belly.  The  other, 
called  the  short  head,  arises,  by  an  acute  fleshy  beginning,  from  the 
linea  aspera  just  below  the  insertion  of  the  glutaeus  magnus,  and  this 
origin  is  continued  along  the  lower  part  of  the  linea  aspera  and  from 
the  ridge  leading  to  the  external  condyle. 

A  thick  tendon  is  gradually  formed  on  the  outside  of  the  muscle, 
which,  descending  along  the  external  face  of  the  external  condyle,  is 
inserted  into  the  superior  face  of  the  head  of  the  fibula  at  its  point,  or 
styloid  process.  A  bursa  is  found  between  this  tendon  and  the  external 
lateral  ligament  of  the  knee. 

This  muscle  flexes  the  leg  on  the  thigh.2 

The  Semi-tendinosus 

Is  on  the  inside  of  the  thigh,  between  the  biceps  and  gracilis.  It  is 
superficial,  being  immediately  under  the  fascia,  and  arises,  in  common 
with  the  biceps,  from  the  back  part  of  the  tuberosity  of  the  ischiura  ;  it 
also  adheres,  for  three  or  four  inches,  to  the  inner  edge  of  the  tendon 
of  this,  the  long  head  of  the  biceps. 

1  Varieties.   Occasionally,  this  muscle  is  absent ;  more  rarely  it  is  divided  into  a  great  num- 
ber of  fasciculi,  amounting  in  one  instance  to  thirty. 

2  Varieties.     Sometimes  the  short  head  does  not  exist,  thereby  affording  an  analogy  with 
animals.     Sometimes  there  is  a  third  head,  but  more  delicate,  which  comes  either  from  the 
tuber  of  the  ischium  or  from  the  long  head,  and  descending  along  the  back  of  the  leg,  runs 
into  the  tendo-Achillis,  corresponding  thereby  with  the  arrangement  of  mam  miferous  animals. 


446  MUSCLES. 

About  four  inches  above  the  knee  it  terminates  in  a  long  round  ten- 
don, which  passes  behind  the  internal  condyle  and  the  head  of  the  tibia, 
and  is  reflected  forwards  to  be  inserted  into  the  side  of  the  tibia,  just 
below  its  tubercle  and  very  near  it,  being  lower  down  than  the  inser- 
tion of  the  tendon  of  the  gracilis.  Its  insertion  is  much  connected  with 
that  of  the  gracilis,  and  is  generally  divided  into  two  slips,  one  above 
the  other. 

Between  its  origin,  that  of  the  long  head  of  the  biceps,  and  the  semi- 
membranosus,  there  is  a  bursa:  one  or  more  are  likewise  found  between 
its  tendon  below,  that  of  the  sartorius,  of  the  gracilis,  and  the  internal 
lateral  ligament  of  the  knee. 

It  flexes  the  leg  on  the  thigh.1 

The  Semi-membranosus 

Is  at  the  inner  side  of  the  thigh;  its  upper  part  is  concealed  by  the 
semi-tendinosus  and  the  origin  of  the  long  head  of  the  biceps,  and  below 
it  projects  between  these  two  muscles.  It  is  in  contact  with  the  poste- 
rior surface  of  the  adductor  magnus. 

It  arises,  by  a  thick  round  tendon,  from  the  exterior  upper  part  of 
the  tuberosity  of  the  ischium,  which  tendon  soon  becomes  flattened,  and 
sends  off  the  muscular  fibres  obliquely  from  its  exterior  edge  to  a  cor- 
responding tendon  below.  The  latter  passes  behind  the  internal  con- 
dyle  and  the  head  of  the  tibia,  and  despatches  a  thin  aponeurotic  mem- 
brane under  the  inner  head  of  the  gastrocnemius,  to  cover  the  posterior 
part  of  the  capsule  of  the  knee  joint,  and  to  be  fastened  to  the  external 
condyle. 

It  is  inserted,  by  a  round  tendon,  into  the  inner  and  back  part  of 
the  head  of  the  tibia,  just  below  the  joint.  The  unfavorable  insertion 
of  this  muscle  is  compensated  for,  by  the  multitude  of  its  fibres,  which 
gives  it  a  great  increase  of  strength. 

A  bursa  exists  between  its  tendon  above  and  the  quadratus ;  another 
exists  between  its  tendinous  termination,  the  internal  head  of  the  gas- 
trocnemius, and  the  capsule  of  the  knee. 

It  flexes  the  leg  on  the  thigh. 


SECT.  III. — MUSCLES  OF  THE  LEG. 

These  muscles  are  situated  anteriorly,  posteriorly,  and  externally. 

The  Tibialis  Anticus 

Is  situated  superficially  under  the  fascia  of  the  leg,  at  the  outside  of 
the  spine  of  the  tibia,  and  in  front  of  the  interosseous  ligament.  It 
arises,  fleshy,  from  the  head  of  the  tibia,  from  its  outer  surface,  spine, 
and  from  the  interosseous  ligament  to  within  three  or  four  inches  of  the 
ankle.  It  also  arises,  by  its  front  surface,  from  the  interior  face  of  the 
fascia  of  the  leg. 

1  Varieties.     Sometimes  it  is  divided  into  three  sections  by  two  transverse  tendinous  lii.es. 


MUSCLES  OF  THE  LEG.  447 

A  rounded  long  tendon  is  formed  in  front  below,  into  which  the 
fleshy  fibres  run  obliquely,  and  which,  passing  through  a  distinct  noose 
of  the  annular  ligament  in  front  of  the  malleolus  internus,  crosses  the 
astragalus  and  os  naviculare,  and  is  inserted  on  the  inner  side  of  the 
sole  of  the  foot  into  the  anterior  part  of  the  base  of  the  cuneiforrne 
internum,  and  into  the  adjacent  part  of  the  metatarsal  bone  of  the 
great  toe. 

A  bursa  surrounds  the  tendon  where  it  passes  beneath  the  annular 
ligament;  another  also  exists  at  its  lower  part. 

This  muscle  corresponds  with  the  radial  extensors  of  the  arm. 

It  bends  the  foot,  and  presents  the  sole  obliquely  inwards. 

The  Extensor  Longus  Digitorum  Pedis 

Is  also  superficially  placed  just  under  the  fascia  of  the  leg  and  in 
front  of  the  fibula,  being  in  contact  above  with  the  tibialis  anticus,  and 
below  with  the  extensor  proprius  pollicis.  It  arises,  tendinous  and 
fleshy,  from  the  outer  part  of  the  head  of  the  tibia ;  from  the  head  of 
the  fibula,  and  almost  the  whole  length  of  its  anterior  angle ;  also 
from  the  upper  part  of  the  interosseous  ligament  and  the  internal  face 
of  the  fascia  of  the  leg. 

Its  fibres  go  obliquely  downwards  and  forwards  to  the  tendon  which 
begins  not  far  from  its  upper  end,  and  descends  along  its  anterior  mar- 
gin. About  the  middle  of  the  leg  the  tendon  splits  into  four,  which 
are  confined  by  the  annular  ligament  of  the  ankle,  and  then  diverging, 
each  is  inserted  into  the  base  of  its  respective  toe,  the  big  one  excepted, 
and  expanded  over  its  back  part  as  far  as  the  last  phalanx. 

When  these  four  tendons  first  reach  the  roots  of  the  toes,  they  ex- 
pand over  the  back  of  the  articulation  there,  and  send  downwards 
triangular  processes  which  are  attached  to  the  base  of  the  first  phalanx, 
and  to  the  tendinous  terminations  of  the  interosseous  muscles.  On 
the  baek  of  the  first  joint  the  tendon  adheres  closely  to  its  synovial 
membrane,  and  is  somewhat  cartilaginous.  At  the  second  joint  the 
tendon  is  inserted  into  the  second  phalanx,  and  splits  partially  into 
two,  which  pass  somewhat  laterally,  and  then  reunite.  The  tendon 
then  adheres  again  closely  to  the  synovial  membrane  of  the  third  arti- 
culation, and  finally  terminates  in  the  base  of  the  third  phalanx. 

A  long  bursa  is  found  enveloping  the  tendons,  where  they  pass  be- 
neath the  annular  ligament  of  the  ankle. 

It  extends  all  the  joints  of  the  small  toes,  and  flexes  the  foot. 

The  Peroneus  Tertius 

Is  rather  a  portion  of  the  extensor  longus  digitorum  pedis ;  is  found 
at  its  lower  outer  part,  and  cannot  be  naturally  separated  from  it.  It 
arises  from  the  anterior  angle  of  the  fibula,  between  its  middle  and 
lower  end. 

It  is  inserted,  by  a  flattened  tendon,  into  the  base  of  the  metatarsal 
bone  of  the  little  toe,  and  assists  in  bending  the  foot. 


, 


448  MUSCLES. 

The  Extensor  Proprius  Pollicis  Pedis 

Is  between  the  lower  part  of  the  tibialis  anticus,  and  of  the  extensor 
longus.  It  arises  from  the  fibula  between  its  anterior  and  internal 
angles,  by  a  tendinous  and  fleshy  origin,  which  commences  about  four 
inches  below  the  head  of  the  fibula,  and  continues  almost  to  its  inferior 
extremity.  A  few  fibres  also  come  from  the  interosseous  ligament,  and 
from  the  lower  part  of  the  tibia. 

The  muscle  being  half  penniform,  the  fibres  run  obliquely  to  a  tendon 
at  its  fore  part,  which  passes  through  a  particular  gutter  of  the  annular 
ligament,  and  over  the  astragalus  and  scaphoides  and  upper  internal 
parts  of  the  foot,  to  be  inserted  into  the  base  of  the  first  and  second 
phalanx  of  the  great  toe.  A  bursa  invests  this  tendon  where  it  passes 
beneath  the  annular  ligament. 

It  extends,  as  its  name  implies,  the  great  toe.1 

On  the  outside  of  the  leg,  between  the  fibula  and  fascia,  are  the  two 
Peronei  muscles. 

The  Peroneus  Longus,  seu  Primus, 

Arises,  tendinous  and  fleshy,  from  the  fore  and  outside  of  the  head 
of  the  fibula,  from  the  space  on  its  outer  side  above,  between  £he 
external  and  anterior  angles;  also,  from  its  external  angle  to  within  a 
short  distance  of  the  ankle. 

A  flattened  thick  tendon,  to  which  the  fibres  pass  obliquely,  consti- 
tutes the  outer  face  of  the  muscle.  This  tendon  is  lodged  in  the  groove 
at  the  posterior  part  of  the  malleolus  externus,  being  confined  to  it  by 
a  thick  ligamentous  noose,  and  furnished  there  with  a  bursa;  it  then 
traverses  the  outer  side  of  the  os  calcis,  where  its  passage  is  marked  by 
a  superficial  sulcus;  from  that  it  runs  upon  the  groove  of  the  os  cu- 
boides,  where  there  is  another  bursa.  It  lies  deep  in  the  sole  of  the 
foot,  covered  by  the  calcaneo-cuboid  ligament,  and  next  to  the  tarsal 
bones,  and  is  inserted  into  the  base  of  the  internal  cuneiform  bone, 
and  into  the  adjacent  part  of  the  metatarsal  bone  of  the  great  toe. 

It  extends  the  foot  and  inclines  the  sole  obliquely  outwards.  It  cor- 
responds with  the  flexor  carpi  ulnaris  of  the  fore  arm. 

As  the  tendon  experiences  much  friction  at  the  ankle,  on  the  os 
calcis,  and  where  it  winds  around  the  os  cuboides,  it  is  not  unusual  to 
find  in  it  there  small  sesamoid  bones,  especially  at  the  latter  place. 

The  Peroneus  Brevis,  seu  Secundus, 

Is  concealed  in  a  great  degree  by  the  peroneus  longus,  being  situated 
between  the  latter  and  the  extensor  longus  digitorum  pedis.  It  arises, 
tendinous  and  fleshy,  from  the  outer  surface  of  the  fibula,  commencing 
about  one-third  of  the  length  of  the  bone  from  its  head,  and  continuing 
almost  to  the  ankle. 

A  tendinous  facing  exists  externally  also  in  this  muscle,  to  which  its 
fibres  proceed  obliquely.  This  tendon  is  continued  through  the  fossa 

1  Varieties.     A  partial  effort  is  sometimes  manifested  to  divide  it  into  two  muscles. 


MUSCLES  OF  THE  LEG.  449 

at  the  back  part  of  the  malleolus  externus,  being  covered  by  the  tendon 
of  the  peroneus  longus,  and  confined  by  the  same  ligamentous  noose ; 
passing  through  the  superficial  fossa  at  the  outer  side  of  the  os  calcis, 
it  is  inserted  into  the  external  part  of  the  base  of  the  metatarsal  bone 
of  the  little  toe. 

It  extends  the  foot,  and  presents  the  sole  obliquely  downwards.  It 
also  corresponds  with  the  flexor  carpi  ulnaris.1 

Triceps  Surse. 

The  muscular  .mass  on  the  back  of  the  leg,  constituting  its  calf,  is 
formed  by  the  two  following  muscles,  which,  with  much  reason,  may  be 
considered  as  composing  only  one.  Anatomists,  who  view  them  in  this 
latter  light,  describe  them  under  the  name  of  Triceps  Surse,  of  which 
the  Gastrocnemius  portion  has  two  heads,  and  the  Soleus,  or  Gastro- 
cnemius  internus,  but  one. 

1.  The  G-astrocnemius  is  the  most  superficial  muscle  on  the  back  of 
the  leg,  and  conceals  the  other,  in  consequence  of  its  breadth.    It  comes 
from  the  condyles  of  the  os  femoris  by  two  heads.     One  head  arises, 
tendinous,  from  the  upper  back  part  of  the  internal  condyle,  and  fleshy 
from  the  adjacent  part  of  the  ridge  leading  to  the  linea  aspera :  the 
other  head  arises,  by  a  broad  tendon  in  the  same  way,  from  the  exter- 
nal condyle  and  the  ridge  above  it.     A  triangular  vacancy  is  left  be- 
tween the  heads  of  the  muscle  for  the  passage  of  the  popliteal  vessels; 
the  heads  then  join  together,  but  in  such  a  way  that  the  appearance  of 
two  bellies  is  distinctly  preserved,  of  which  the  internal  is  the  larger. 
The  muscular  fibres  pass  from  a  broad  tendinous  facing  on  the  back 
to  a  corresponding  one  on  the  front  surface  of  the  muscle,  from  the  latter 
of  which  comes  the  Tendo-Achillis. 

2.  The  Soleus  is  beneath  the  Gastrocnemius,  and  arises,  fleshy,  from 
the  posterior  part  of  the  head  of  the  fibula,  and  from  the  external  angle 
of  that  bone,  for  two-thirds  of  its  length  down,  behind  the  peroneus 
longus.     It  also  arises,  fleshy,  from  the  oblique  ridge  on  the  posterior 
surface  of  the  tibia,  just  at  the  lower  edge  of  the  popliteus  muscle,  and 
from  the  internal  angle  of  the  tibia  for  four  or  five  inches.     The  two 
origins  are  separated  for  the  passage  of  the  posterior  tibial  vessels. 

The  body  of  this  muscle  has  a  great  intermixture  of  tendinous  mat- 
ter with  it,  and  from  its  lower  extremity  proceeds  another  origin  of  the 
tendo-Achillis.  About  three  or  four  inches  above  the  heel,  this  tendon 
joins  the  anterior  face  of  the  tendon  of  the  gastrocnemius,  and  by  the 
union  of  the  two  the  tendo-Achillis  is  completed,  and  then  inserted  into 
the  posterior  surface  of  the  os  calcis  near  its  tuberosities.  The  tendon 
becomes  more  round  as  it  descends. 

These  muscles  extend  the  foot,  and  are  all  important  in  walking.  A 
bursa  is  between  their  tendon  and  the  os  calcis. 

1  Varieties.     Sometimes  it  is  double. 

VOL.  i.— 29 


450  MUSCLES. 

The  Plantaris 

Is  a  singular  little  muscle,  concealed  by  the  gastrocnemius,  and  has 
a  short  fleshy  belly  and  a  long  tendon.  It  arises,  fleshy,  from  the  ridge 
of  the  os  femoris,  just  above  the  external  condyle,  passes  across  the 
capsular  ligament  of  the  joint,  and  adheres  to  it  in  its  course ;  the  belly 
terminates  somewhat  below  the  head  of  the  tibia,  in  a  long,  delicate 
tendon,  which  descends  between  the  inner  part  of  the  soleus  and  the 
gastrocnemius. 

At  the  place  where  the  tendons  of  these  unite,  the  tendon  of  the 
plantaris  emerges  from  between  them,  and,  running  at  the  inner  edge 
of  the  tendo-Achillis,  is  inserted  into  the  inside  of  the  os  calcis,  just 
before  the  insertion  of  the  latter. 

It  extends  the  foot.  This  muscle  is  sometimes  wanting.  It  contri- 
butes so  little  to  the  motions  of  the  foot,  and,  in  other  respects,  is  of 
such  doubtful  use,  that  its  proper  destination  is  uncertain,  or  at  any 
rate  may  be  limited  to  the  drawing  of  the  capsular  ligament  out  of  the 
way  in  the  flexions  of  the  leg.  In  some  mammiferous  animals  it  is 
large  and  important.  In  the  human  subject  it  is  one  of  the  links  con- 
necting us  with  animals,  of  which  there  are  so  many  evidences  in  the 
muscular  system. 

The  Popliteus 

Is  a  triangular  muscle  on  the  back  of  the  knee  joint.  It  arises  from 
a  deep  depression  on  the  exterior  face  of  the  external  condyle,  by  a 
thick  round  tendon,  which  passes  through  the  capsular  ligament,  and 
is  connected  with  the  external  semilunar  cartilage.  It  then  forms  a 
fleshy  belly  which  proceeds  obliquely  inwards  and  downwards. 

It  is  inserted  fleshy  into  the  oblique  ridge  on  the  back  of  the  tibia,  just 
below  its  head,  and  into  the  triangular  depression  above  it.  A  bursa 
exists  between  its  origin  and  the  capsular  ligament ;  its  tendon  is  in 
contact  with  the  synovial  membrane  of  the  joint. 

It  bends  the  leg,  and  rotates  it  inwards,  when  bent. 

The  Flexor  Longus  Digitorum  Pedis  Perforans 

Is  behind  the  tibia,  and  at  the  inner  edge  of  the  tibialis  posticus. 
It  commences,  by  an  acute,  tendinous  and  fleshy  beginning,  from 
the  back  of  the  tibia,  a  little  below  the  popliteus  muscle ;  its  origin  is 
continued  along  the  posterior  surface  of  the  tibia  almost  to  the  ankle 
joint.  It  arises,  also,  by  tendinous  and  fleshy  fibres,  from  the  outer 
edge  of  the  tibia,  just  above  its  connection  with  the  fibula  at  the  ankle: 
the  latter  origin  is  frequently  deficient,  and  between  this  double  order 
of  fibres  the  tibialis  posticus  passes. 

The  fibres  go  obliquely  at  the  posterior  edge  of  the  muscle,  into  a 
tendon,  which  runs  in  the  groove  behind  the  internal  malleolus,  and  is 
confined  there  by  a  strong  ligamentous  sheath.  The  tendon  is  placed 
behind,  and  within  the  tendon  of  the  tibialis  posticus.  The  tendon  then 
gets  to  the  sole  of  the  foot  along  the  sinuosity  of  the  os  calcis,  and 
being  joined  by  a  considerable  tendon,  detached  from  the  flexor  longus 


MUSCLES  OF  THE  LEG.  451 

pollicis,  it  divides  into  four  brandies  which  are  appropriated  to  the 
four  smaller  toes. 

These  tendons  are  inserted  into  the  base  of  the  third  phalanges  of  the 
lesser  toes,  are  very  near  the  tarsal  bones,  and,  from  perforating  the  ten- 
dons of  the  flexor  brevis,  correspond  with  the  flexor  perforans  of  the  hand. 
A  bursa  exists  where  the  tendon  passes  along  the  tibia  and  theos  calcis  ; 
and  another  is  found  in  the  sole  of  the  foot,  enveloping  this  tendon  and 
that  of  the  flexor  longus  pollicis. 

A  fifth  tendon  is  sometimes  observed,  which  splits  and  goes  to  the 
second  phalanx  of  the  small  toe  :  this  occurs  when  the  latter  is  not  sup- 
plied from  the  flexor  brevis. 

This  muscle  flexes  the  small  toes,  and  extends  the  foot. 

The  Flexor  Longus  Pollicis  Pedis 

Is  a  stout  muscle  formed  of  oblique  fibres,  and  situated  on  the  back 
part  of  the  fibula,  at  the  outer  side  of  the  tibialis  posticus.  It  arises 
by  an  acute,  tendinous  and  fleshy  beginning,  from  the  posterior  flat  sur- 
face of  the  fibula,  commencing  about  three  inches  from  its  head,  and 
continues  almost  to  the  ankle. 

The  tendon  of  this  muscle  is  large  and  round;  it  forms  gradually, 
and  constitutes  a  facing  to  the  posterior  edge  of  the  muscle.  It  passes 
through  a  superficial  fossa  of  the  tibia,  at  the  back  of  the  angle  near  its 
middle,  and  from  thence  through  a  notch  in  the  back  edge  of  the  astra- 
galus to  the  sole  of  the  foot;  at  the  latter  place  it  crosses  the  tendon 
of  the  flexor  longus  digitorum,  and  gives  off  to  it  the  branch  just  men- 
tioned, which  goes,  principally,  to  the  second  toe.  This  tendon  is  deeper 
seated  in  the  foot  than  the  other. 

The  tendon  of  the  flexor  longus  pollicis  is  inserted  into  the  second 
phalanx  of  the  great  toe. 

It  bends  the  great  toe,  and  from  its  connection  with  the  others  will 
bend  them  also.  A  bursa  invests  its  tendon  in  the  canal  of  the  astra- 
galus, and  along  the  os  calcis;  another,  as  stated,  is  common  to  it  and 
the  flexor  perforans  muscle;  and  a  third  invests  the  tendon  along  the 
metatarsal  bone,  and  the  first  phalanx  of  the  great  toe.1 

The  Tibialis  Posticus 

Is  placed  between,  and  concealed  by  the  last  two  muscles.  It  arises 
by  a  narrow  fleshy  beginning,  from  the  front  of  the  tibia,  at  the  under 
surface  of  the  process  which  joins  it  to  the  fibula,  and  then  gets  to  the 
back  of  the  leg  through  the  hole  in  the  upper  part  of  the  interosseous 
ligament.  It  continues  its  origin  from  the  whole  of  the  interosseous 
ligament,  and  from  the  surfaces  of  the  tibia  and  fibula  bordering  on 
this  ligament,  excepting  one-third  of  the  lower  part  of  the  fibula,  arid 
rather  more  of  the  lower  part  of  the  tibia. 

The  fleshy  fibres  run  obliquely  to  a  middle  tendon  which  passes  in 
the  groove  at  the  back  of  the  malleolus  internus,  and  is  confined  there 

1  The  variations  in  this  muscle  consist,  principally,  in  the  manner  of  distributing  its  tendon 
to  that  of  the  small  toes,  and  frequently  this  connection  is  deficient. 


452  MUSCLES. 

by  a  fibro-cartilaginous  noose,  and  invested  by  a  bursa.  It  is  inserted 
into  the  posterior  internal  part  of  the  os  naviculare  or  scaphoides,  at 
its  tuberosity ;  and  also  divides  in  such  a  way  as  to  be  inserted  into  the 
internal  and  external  cuneiform  bones,  into  the  os  cuboides,  and  os 
calcis. 

It  extends  the  foot,  and  presents  the  sole  obliquely  inwards.     It  cor- 
responds with  the  flexor  radialis  of  the  hand. 


SECT.  IV. — OF  THE  MUSCLES  OF  THE  FOOT. 

The  Extensor  Brevis  Digitorum  Pedis 

Is  a  muscle  situated  on  the  superior  surface  of  the  foot.  It  is  placed 
beneath  the  tendons  of  the  extensor  longus,  and  arises,  tendinous  and 
fleshy,  from  the  fore  upper  part  of  the  greater  apophysis  of  the  os  calcis, 
being  intermixed  with  the  origin  of  the  annular  ligament  of  the  ankle. 
It  forms  a  short,  fleshy  belly,  which  is  partially  divided  into  four  parts; 
from  these  parts  proceed  as  many  tendons,  which,  crossing  very  obliquely 
the  tendons  of  the  extensor  longus,  are  inserted  into  the  great  toe,  and 
the  three  next  toes,  by  joining  with  the  tendons  of  the  extensor  longus, 
which  are  spread  over  their  backs.  The  tendon  going  to  the  great  toe 
has  its  principal  insertion  into  the  first  phalanx. 

It  extends  the  toes.1 

When  the  Aponeurosis  Plantaris  is  removed  from  the  sole  of  the  foot, 
we  see  three  muscles  ;  the  middle  one  having  been  covered  by  the  large 
central  portion  of  the  Aponeurosis,  is  the  Flexor  Brevis  Digitorum 
Pedis;  the  outer  is  the  Abductor  Minimi  Digiti  Pedis;  and  the  inner, 
the  Abductor  Pollicis  Pedis. 

The  Flexor  Brevis  Digitorum  Pedis 

Arises,  fleshy,  from  the  larger  tuberosity  of  the  os  calcis,  by  a  nar- 
row beginning;  also  from  the  upper  surface  of  the  aponeurosis  planta- 
ris,  and  the  aponeurotic  septa  between  itself  and  the  contiguous 
muscles. 

It  forms  a  fleshy  belly,  going  nearly  as  far  forwards  as  the  middle 
of  the  metatarsal  bones;  there  it  divides  into  four  tendons,  which  go 
to  the  four  smaller  toes.  These  are  perforated  by  the  tendons  of  the 
flexor  longus,  and  are  inserted  into  the  sides  of  the  second  phalanges. 
The  tendon  for  the  little  toe  is  often  deficient. 

It  bends  the  second  joint  of  the  toes.          * 

By  detaching  this  muscle  from  its  origin,  and  turning  it  down,  we 
bring  into  view  the  tendon  of  the  Flexor  Longus  Digitorum  Pedis ;  and 
the  attachment  of  the  latter  to  the  tendinous  slip  from  the  Flexor 
Longus  Pollicis, — to  the  Flexor  Accessorius,  or  Massa  carnea  Jacobi 
Sylvii, — and  to  the  Lumbricales  Muscles. 

1  Varieties.  The  internal  part,  or  belly,  is  sometimes  distinct  from  the  adjoining.  In  some 
very  rare  cases  all  the  bellies  are  insulated,  as  in  birds.  Sometimes  it  sends  a  tendon  to  the 
little  toe. 


MUSCLES  OF  THE  FOOT. 
Fig.  138. 


453 


A  view  of  the  Muscles  on  the  back  of  the  leg.  1.  Tendon  of  the  biceps.  2.  Inner  hamstring  ten- 
dons. 3.  Popliteal  space.  4.  Gastrocnemius.  5.  Soleus.  6.  Tendo-Achillis.  7.  Its  insertion  on  the 
os  calcis.  8.  Tendons  of  the  peroneus  longus  and  brevis-.  9.  Tendons  of  the  tibialis  posticus  and 
flexor  longus  digitorum  behind  the  internal  malleolus. 

The  Flexor  Accessorius 

Is  at  the  outside  of  the  tendon  of  the  flexor  longus  digitorum  pedis. 
It  arises,  fleshy,  from  the  inside  of  the  sinuosity  of  the  os  calcis,  and, 
by  a  thin  tendon,  from  the  outside  of  the  same  bone  before  its  posterior 
tuberosities. 

It  is  inserted,  fleshy,  into  the  outside  of  the  tendon  of  the  flexor 
longus  just  at  its  division  into  four  tendons.  Like  a  second  hand  to  a 
rope,  it  assists  in  flexing  the  toes. 

The  Lumbricales  Pedis 

Are  four  small  tapering  muscles,  which  arise  from  the  tendon  of  the 
flexor  longus  digitorum  pedis,  just  after  its  division,  or  while  it  is  in 
the  act  of  dividing.  One  of  them  is  appropriated  to  each  lesser  toe, 
and  is  inserted  into  the  inside  of  its  first  phalanx,  and  into  the  tendi- 
nous expansion  that  is  sent  off  from  the  extensor  muscles  to  cover  its 
dorsum. 

They  increase  the  flexion  of  the  toes,  and  draw  them  inwards. 


454  MUSCLES. 

The  Abductor  Pollicis  Pedis 

Arises,  tendinous  and  fleshy,  from  the  internal  anterior  part  of  the 
large  tuberosity  of  the  os  calcis;  from  a  ligament  being  a  part  of  the 
aponeurosis  of  the  sole  of  the  foot  extended  from  this  tuberosity  to  the 
sheath  of  the  tendon  of  the  tibialis  posticus ;  from  the  internal  side  of 
the  naviculare,  and  from  the  cuneiforme  internum. 

It  forms  the  internal  margin  of  the  sole  of  the  foot,  and  is  inserted, 
tendinous,  into  the  internal  sesamoid  bone,  and  into  the  base  of  the 
first  phalanx  of  the  great  toe. 

It  draws  the  great  toe  from  the  rest. 

From  the  inner  division  of  the  Aponeurosis  plantaris,  a  muscle  some- 
times is  found  to  arise  in  the  hollow  of  the  foot,  and  to  cross  the  latter 
in  an  outward  direction,  to  be  inserted  into  the  skin  of  the  foot  tendi- 
nously ;  it  is  an  inch  long,  and  about  three  lines  wide.1 

The  Flexor  Brevis  Pollicis  Pedis 

Is  situated  immediately  at  the  exterior  edge  of  the  abductor  pollicis. 
It  consists  of  two  bellies,  which  are  parallel  with  each  other,  and  sepa- 
rated by  the  tendon  of  the  flexor  longus  pollicis ;  one  is  inseparably 
connected  with  the  tendon  of  the  abductor  pollicis,  and  the  other  with 
the  adductor  pollicis  pedis. 

It  arises,  in  common  with  the  calcaneo-cuboid  ligament,  tendinous, 
from  the  under* part  of  the  os  calcis,  just  behind  its  connection  with 
the  os  cuboides,  and  from  the  under  part  of  the  external  cuneiform 
bone. 

The  internal  belly  is  inserted,  tendinous,  into  the  internal  sesamoid 
bone,  along  with  the  tendon  of  the  abductor  pollicis,  and  the  external 
belly  is  inserted,  tendinous,  into  the  external  sesamoid  bone,  along  with 
the  tendon  of  the  adductor  pollicis.  Each  insertion  is  continued  to  the 
base  of  the  first  phalanx  of  the  great  toe. 

It  flexes  the  great  toe. 

The  Adductor  Pollicis  Pedis 

Is  situated  at  the  outside  of  the  flexor  brevis  pollicis,  and  is  extended 
obliquely  across  the  metatarsal  bones.  It  arises,  tendinous,  at  the 
external  part  of  the  foot,  from  the  calcaneo-cuboid  ligament,  and  from 
the  bases  of  the  three  outer  metatarsal  bones. 

It  is  inserted,  tendinous,  into  the  external  sesamoid  bone,  which 
insertion  is  continued  to  the  first  phalanx  «of  the  great  toe.  It  is 
closely  united  to  the  tendon  of  the  external  head  of  the  flexor  brevis 
pollicis. 

It  draws  the  great  toe  towards  the  others. 

1  An  example  eccurred  to  me*  in  a  black  female,  January  15th,  1845. 


MUSCLES  OF  THE  FOOT.  455 

The  Abductor  Minimi  Digiti  Pedis 

Forms  the  external  margin  of  the  sole  of  the  foot,  and  is  imme- 
diately beneath  the  aponeurosis  plantaris.  It  arises,  tendinous  and 
fleshy,  from  the  outer  tuberosity  of  the  os  calcis,  and  also  from  the 
exterior  part  of  the  base  of  the  metatarsal  bone  of  the  little  toe. 

It  is  inserted  by  a  rounded  tendon  into  the  exterior  part  of  the  base 
of  the  first  phalanx  of  the  little  toe. 

It  draws  the  little  toe  from  the  other  toes. 

The  Flexor  Brevis  Minimi  Digiti  Pedis 

Is  just  within  the  tendon  of  the  abductor  minimi  digiti.  It  arises 
from  the  calcaneo-cuboid  ligament  as  extended  from  the  tuberosity  of 
the  cuboid  bone  to  the  bases  of  the  two  outer  metatarsal  bones ;  also 
from  the  base  of  the  outer  or  fifth  metatarsal  bone. 

It  is  inserted,  by  a  tendon,  into  the  lower  part  of  the  first  phalanx 
of  the  little  toe,  at  its  base,  and  into  the  head  of  the  metatarsal  bone 
of  the  same  toe. 

It  bends  the  little  toe. 

The  Transversalis  Pedis 

Is  placed  beneath  the  tendons  of  the  flexor  muscles.1  It  is  small, 
and  lies  across  the  anterior  extremities  of  the  metatarsal  bones.  It 
arises,  tendinous,  from  the  capsular  ligament  of  the  first  joint  of  the 
little  toe;  it  also  arises  from  the  capsular  ligament  of  the  first  joint  of 
the  next  toe. 

It  is  inserted  into  the  exterior  face  of  the  common  tendon  of  the 
adductor  and  the  flexor  brevis  pollicis,  at  the  external  sesamoid  bone. 

It  approximates  the  heads  of  the  metatarsal  bones. 

The  Interosseous  Muscles  are  seven  in  number,  four  of  which  may 
be  seen  on  the  upper  surface  of  the  foot.  There  are  two  to  the  first 
smaller  toe,  two  to  the  second,  two  to  the  third,  and  one  to  the  fourth, 
or  little  toe.  The  muscles  seen  on  the  upper  side  of  the  foot  are 
double-headed,  that  is,  they  arise  from  the  contiguous  surfaces  of  the 
metatarsal  bones. 

The  Interosseus  Primus,  Digiti  Primi,  or  the  Abductor  Indicis  Pedis, 

Is  seen  superiorly.  It  is  placed  between  the  metatarsal  bone  of  the 
great  toe,  and  the  first  small  toe,  and  arises,  fleshy,  by  a  double  head, 
from  the  opposed  surfaces  of  their  roots  and  bodies. 

It  is  inserted,  tendinous,  into  the  inside  of  the  root  of  the  first  joint 
or  phalanx  of  the  first  small  toe,  and  pulls  it  inwards. 

1  The  sole  is  presumed  to  be  upwards. 


456  MUSCLES. 

The  Interosseus  Secundus,  Digiti  Primi,  or  the  Adductor  Indicis 

Pedis, 

Is  also  superficial  or  above.  It  is  situated  between  the  metatarsal 
bones  of  the  first  and  second  small  toes,  arising  from  the  opposed  sur- 
faces of  their  roots  and  bodies  by  a  double,  fleshy,  and  tendinous  head. 

It  is  inserted  into  the  outside  of  the  first  phalanx  of  the  same  toe, 
by  a  tendon. 

It  draws  this  toe  outwards. 

The  Interosseus  Secundus,  Digiti  Secundi,  or  the  Adductor  Medii 

Digiti  Pedis, 

Is  seen  at  the  upper  part  of  the  foot  between  the  second  and  third 
metatarsal  bones  of  the  lesser  toes,  arising  from  the  opposite  surfaces 
of  their  roots  and  bodies. 

It  is  inserted,  tendinous,  into  the  outside  of  the  base  of  the  first 
phalanx  of  the  second  small  toe. 

It  draws  this  toe  outwards. 

The  Interosseus  Becundus,  or  the  Adductor  Digiti  Tertii  Pedis, 

Is  seen  on  the  upper  surface  of  the  foot,  occupying  the  interval  of 
the  metatarsal  bones  of  the  third  and  fourth  small  toes,  and  arises,  by  a 
double  head,  from  the  opposite  surfaces  of  their  roots  and  bodies. 

It  is  inserted,  tendinous,  into  the  outside  of  the  root  of  the  first 
phalanx  of  the  third  small  toe. 

It  draws  this  toe  outwards. 

The  Interosseus  Primus,  Digiti  Secundi,  or  the  Jlbductor  Medii 

Digiti  Pedis, 

Is  at  the  bottom  of  the  foot,  and  arises  from  the  inside  of  the  meta- 
tarsal bone  of  the  second  smaller  toe. 

It  is  inserted  into  the  inside  of  the  first  phalanx  of  the  second  toe. 
It  draws  this  toe  inwards. 

The  Interosseus  Primus,  or  the  Abductor  Digiti  Tertii  Pedis, 

Is  in  the  sole  of  the  foot.  It  arises  from  the  inside  of  the  meta- 
tarsal bone  of  the  third  smaller  toe,  beginning  near  its  root,  and  is 
inserted,  tendinous,  into  the  inside  of  the  base  of  the  first  phalanx  of 
the  same  toe. 

It  draws  this  toe  inwards. 

The  Interosseus,  or  the  Adductor  Digiti  Minimi  Pedis, 

Is  on  the  under  surface  of  the  foot.  It  arises  from  the  inside  of  the 
base  and  body  of  the  metatarsal  bone  of  the  fourth  smaller,  or  the  little 
toe,  and  is  inserted,  tendinous,  into  the  inside  of  the  first  phalanx  of 
the  little  toe. 

It  draws  this  toe  inwards. 


BOOK   IV. 


OF  THE  ORGANS  OF  DIGESTION. 

THE  Organs  of  Digestion  consist  in  an  uninterrupted  canal  extending 
from  the  lips  to  the  anus,  and  of  numerous  glandular  organs  placed 
all  along  its  track,  for  pouring  their  secretions  into  it. 

This  canal,  called  Alimentary  (ductus  cibarius],  is  in  three  princi- 
pal portions :  the  superior ;  the  middle ;  and  the  inferior  or  terminat- 
ing. The  superior  portion  is  composed  of  the  mouth,  the  pharynx, 
and  the  oesophagus: — the  middle  of  the  stomach  and  small  intestines: 
and  the  inferior,  of  the  large  intestines. 

The  Glandular  organs  are  the  salivary  glands,  the  pancreas,  the 
liver,  the  spleen,  and  an  extremely  numerous  set  of  muciparous  glands, 
extending  from  one  end  to  the  other  of  the  canal. 

The  organs  of  digestion  maybe  divided,  according  to  their  physiolo- 
gical functions,  into  those  of  mastication  and  deglutition;  and  into  those 
of  assimilation. 


BOOK    IV. 

PART  I. 
ORGANS  OF  MASTICATION  AND  DEGLUTITION. 


CHAPTER  I. 
OF  THE  MOUTH. 

THE  Mouth  (cavum  oris)  occupies  the  space  in  the  inferior  part  of 
the  face,  between  the  upper  and  the  lower  jaw.  It  is  separated  from 
the  nose  by  the  palatine  processes  of  the  superior  maxillary  and  palate 
bones,  and  by  the  soft  palate,  which  is  continued  backwards  from  them. 
It  extends  from  the  lips,  in  front,  to  the  soft  palate  and  pharynx  behind, 
and  its  floor  is  formed  by  the  mylo-hyoid  muscles. 

Fig.  139. 


A  view  of  the  cavity  of  the  Mouth,  as  shown  by  dividing:  the  Angles  of  the  Mouth  and  turning  off  the 
Lips. — 1.  The  upper  lip  turned  up.  2.  Its  frsenum.  3.  The  lower  lip  turned  down.  4.  Its  fraenum 
5.  Internal  surface  of  the  cheeks.  6.  Opening  of  duct  of  Stenp.  7.  Roof  of  the  mouth.  8.  The  ante- 
rior portion  of  the  lateral  half  arches.  9.  The  posterior  portion  of  the  lateral  half  arches.  10.  The 
velum  pendulum  palati.  11.  The  tonsils.  12.  The  tongue. 

The  anterior  and  lateral  periphery  of  the  mouth  is  constituted  by  the 
muscles  of  the  lips  and  cheeks,  covered  externally  by  common  integu- 


OF  THE  MOUTH.  459 

ments,  and  internally  by  the  lining  membrane  of  the  mouth.  The 
cavity  of  the  latter  is  divided  into  two  portions  by  the  projection  of  the 
teeth  and  of  the  alveolar  processes  of  the  upper  and  of  the  under  jaw; 
these  two  portions,  when  the  teeth  are  complete,  are  separated  from  each 
other  while  the  mouth  is  closed.  The  anterior  portion,  which  is  some- 
times called  the  vestibule  of  the  mouth  (vestibulum  oris],  varies  its 
size  very  considerably  in  mastication,  and  has  its  parietes  extremely 
movable.  The  capaciousness  of  the  posterior  admits  also  of  much 
change,  by  the  motions  of  the  tongue  and  by  the  depression  of  the  lower 
jaw. 

The  whole  cavity  of  the  mouth  is  lined  by  a  membrane  (membrana 
om),  continued  over  the  lips  from  the  skin,  and,  in  many  respects, 
strongly  resembling  the  texture  of  the  latter,  inclusive  of  the  papillae 
tactus;  it  is,  however,  much  finer;  is  furnished  everywhere  with  an 
epidermis ;  is  very  vascular,  and  has  beneath  it  a  great  number  of  small 
glands.  Its  texture  undergoes  some  changes,  according  to  its  position, 
upon  the  lips  and  cheeks,  upon  the  gums  and  palate,  and  upon  the 
tongue;  all  of  which  will  be  explained  in  due  season. 

This  lining  membrane  of  the  mouth,  for  the  most  part  thin  and  very 
flexible,  forms,  at  several  points,  folds  or  duplicatures.  Four  of  them 
are  situated  on  the  middle  line  of  the  mouth,  and  are  called  frenula; 
one  goes  from  the  posterior  face  of  the  upper  lip  to  the  middle  palate 
suture  in  front  of  the  central  alveolar  processes  of  the  upper  jaw;  a 
second  goes  from  the  posterior  face  of  the  lower  lip  to  the  front  of  the 
symphysis  of  the  lower  jaw ;  a  third  goes  from  the  under  part  of  the 
tongue  to  the  posterior  face  of  the  symphysis  of  the  lower  jaw  (frsenu- 
lum  linguse)',  and  the  fourth  goes  from  the  front  of  the  epiglottis  carti- 
lage to  the  middle  of  the  root  of  the  tongue.  Besides  these,  there  are 
some  other  duplications,  which  will  be  mentioned  in  their  proper  order. 

Fig.  140.  Fig.  141. 


Fig.  140.    Distribution  of  the  nerves  of  touch  upon  the  surface  of  the  lip,  as  exhibited  under   the 
microscope  by  a  thin  perpendicular  section  of  the  skin. 
Fig.  141.     Capillary  net-work  upon  the  margin  of  the  lips  ;  highly  magnified. 

The  lips  (labia)  are  always  somewhat  thicker  at  their  loose  margins 
than  elsewhere  ;  the  skin  which  covers  them  there,  is  remarkable  for 
its  vascularity,  and  changes  its  texture  insensibly,  as  it  is  continued 
from  the  face  to  the  lining  membrane  of  the  mouth. 

The  upper  lip  is  longer  and  thicker  than  the  lower,  is  somewhat 
pointed  in  the  centre,  and  has  on  its  front  surface  a  vertical  depression 
(philtrum))  beginning  at  the  septum  of  the  nose  and  going  downwards 


460  OKGANS  OF  DIGESTION. 

to  the  centre  of  the  lip.  This  depression  is  the  remains  of  a  fissure 
which  always  exists  between  the  two  halves  of  the  lip  in  the  early  foetal 
or  forming  stage.  The  junction  of  the  extremities  of  the  lips  consti- 
tutes the  corners  of  the  mouth  (anguli  oris). 

The  lips  are  composed  of  muscular  fibres,  much  blended  with  adi- 
pose matter.  The  muscles  which  concur  to  form  them  are  the  orbicu- 
laris  oris  and  the  buccinators;  besides  which,  the  upper  lip  is  furnished 
on  each  side  with  the  two  levatores,  with  the  depressor  and  the  zygo- 
matici ;  while  the  lower  lip  has  its  two  depressors  and  a  levator.  (See 
Muscles  of  the  Face.) 


CHAPTER  II. 
OF  THE  TEETH. 

THE  Teeth  (denies)  are  by  far  the  hardest  portions  of  the  human 
fabric  ;  and  though  they  bear  in  their  composition  and  appearance  a 
strong  analogy  with  bone,  yet  they  differ  from  it  in  their  more  limited 
duration,  in  their  mode  of  development,  their  partial  nudity,  their  mode 
of  nutrition,  and  in  the  manner  by  which  they  are  united  to  the  body. 


SECTION  I. 

The  whole  number  of  teeth  in  the  adult  is  thirty-two,  sixteen  in  each 
jaw,  and,  when  healthy,  they  are  all  fixed  with  so  much  firmness  by  the 
gomphosis  articulation,  that  the  very  slight  degree  of  motion  which, 
by  force,  they  may  be  caused  to  execute,  is  scarcely  perceptible. 

The  greater  part  of  the  length  of  each  tooth  is  implanted  into  the 
alveolar  process  of  the  jaw,  and  the  part  so  fixed  is  technically  called 
the  root ;  immediately  beyond  this  a  small  portion  of  the  tooth  is  em- 
braced by  the  gum,  this  is  the  neck ;  and  the  free,  or  projecting  part  of 
the  tooth,  covered  with  a  shining  porcelain-like  layer  called  the  enamel, 
is  its  body.  The  body  is  hollow,  and  has  a  conical  extension  along 
each  root  to  the  point  of  the  latter,  where  it  terminates  in  an  orifice, 
the  size  of  a  small  bristle. 

The  differences  existing  in  their  shape  have  caused  anatomists  to 
classify  them  accordingly;  on  each  side  of  the  middle  line  of  each  jaw 
there  are  two  Incisors,  one  Cuspated,  two  Bicuspated,  and  three  Molar 
teeth.  There  are  also  some  peculiarities,  as  they  belong  to  the  upper 
or  to  the  lower  jaw ;  but  they  correspond  exactly  with  their  fellows  on 
the  opposite  side  of  the  same  jaw. 

The  Incisors  (denies  incisivi]  are  next  to  the  middle  line,  and  are 
named  from  their  being  brought  to  a  straight  cutting  edge,  like  a  chisel, 
they  being  bevelled  from  behind.  They  are  somewhat  convex  on  their 
anterior  face,  but  behind  they  are  very  concave.  0 vying  to  their  thin- 


OF  THE  TEETH.  461 

ness  for  some  distance  from  the  cutting  edge,  they  are  apt  to  be  broken. 
In  early  life,  their  cutting  edge  is  slightly  serrated.  They  have  each 
but  one  root,  which  is  conoidal,  terminates  by  a  small  point,  and  is  not 
unfrequently  impressed  longitudinally  on  each  side  by  a  superficial 
furrow. 

The  central  incisors  of  the  upper  jaw  are  broader  and  longer  than 
the  outer  ones  ;  the  anterior  face  of  the  latter  is  more  convex,  and  their 
cutting  edge  more  rounded.  The  incisors  of  the  lower  jaw  are  much 
narrower  than  those  of  the  upper,  and  have  their  roots  flattened  on  the 
sides.  They  do  not  differ  remarkably  among  themselves,  except  that 
the  external  ones  are  somewhat  wider  than  the  internal. 

The  enamel  of  the  incisors  is  continued  farther  down,  and  is  thicker 
on  their  anterior  and  posterior  faces  than  laterally;  it  is  also  thicker 
on  the  front  than  on  the  back  part.1 

The  Cuspated  Teeth  (denies  cuspidata,  canini)  are  next  to  the 
incisors,  one  on  each  side.  Their  body  is  conoidal,  and  is  brought  to 
a  sharp  point  at  its  summit;  the  principal  obliquity  in  effecting  the 
latter,  being  on  the  side  of  the  interior  of  the  mouth.  They  are 
more  convex  externally  than  the  incisors,  but  not  so  concave  in- 
ternally; they  are  also  thicker  and  more  cylindroid.  They  have 
each  but  one  root,  which  is  conoidal,  and  which,  as  also  the  body,  is 
longer  than  the  corresponding  portion  of  any  of  the  other  teeth.  They 
stand  nearly  perpendicularly,  and  are  more  covered  on  their  sides  with 
enamel  than  the  incisors. 

The  cuspated  teeth  of  the  upper  jaw  have  longer  roots  than  those 
of  the  lower,  and  are  called,  in  common  language,  eye-teeth :  those  of 
the  lower  jaw  are  called  stomach  teeth. 

The  Bicuspated  Teeth  (dentes  bicuspidati),  two  in  number  on  each 
side,  are  situated  behind  the  cuspate ;  they  are  also  called  small  molar. 
They  are  almost  precisely  alike,  with  the  exception  that  the  first  is 
smaller  than  the  other,  and  resembles  rather  more  the  type  of  the  cus- 
pidatus  than  the  second  does.  Their  body  is  very  nearly  cylindrical, 
being  flattened,  however,  on  the  faces  next  to  the  adjoining  teeth. 
The  masticating  surface  of  the  body  is  formed  into  two  points,  whence 
the  name;  one  external,  and  the  other  internal:  the  former  is  the 
longer  and  thicker,  and  consequently,  the  most  conspicuous.  The 
enamel  forms  an  almost  circular  crown,  covering  the  bodies  of  these 
teeth.  The  root  of  each  one  is  single,  but  has  a  deep  and  well  marked 
fossa  on  each  side  running  its  whole  length,  and  presenting  the  sem- 
blance of  an  effort  at  duplicity;  it  is  also  conoidal,  and  sometimes  in 
the  upper  jaw  bifurcated  at  its  end. 

The  bicuspate  teeth  of  the  upper  and  of  the  lower  jaw  resemble 
each  other  so  strongly  that  the  difference  between  them  is  not  striking; 
it  is,  however,  determined  by  those  of  the  upper  jaw  being  rather  more 
voluminous  and  ovoidal  in  their  bodies,  and  having  rather  longer  and 
larger  roots. 

1  Natural  History  of  the  Human  Teeth,  by  J.  Hunter,  London,  1778. 


462  ORGANS  OF  DIGESTION. 

The  Molar  Teeth  (denies  molares),  three  in  number,  on  each  side, 
succeed  the  bicuspated.  They  are  well  characterized  by  their  greater 
size.  Their  bodies  are  almost  cuboidal,  with  rounded  angles,  and  are 
protected  with  a  circular  crown  of  enamel ;  their  grinding  surface  has 
five  points,  three  externally,  and  two  internally :  the  rule,  however,  is 
not  uniform,  as  they  frequently  have  only  four,  and  sometimes  in  the 
upper  jaw  only  three  points. 

The  first  molar  is  the  largest  of  any,  and  very  generally  has  five 
points ;  in  the  upper  jaw  it  has  three  roots,  two  of  which  are  outward, 
and  the  other  inward;  but  in  the  lower  jaw  it  has  only  two  roots,  one 
before  the  other. 

The  second  molar  of  each  jaw,  with  the  exception  of  its  being  smaller 
than  the  first,  presents  no  essential  difference  from  it,  either  in  regard 
to  its  body  or  roots.  The  fifth  point  is  sometimes  not  so  well  deve- 
loped. 

The  third  molar  resembles  the  other  two  in  its  body,  but  is  smaller 
than  either  of  them.  Most  frequently  its  roots,  instead  of  diverging 
from  each  other  and  standing  out  distinctly,  are  imperfectly  developed, 
and  stick  together.  Some  slight  separation  at  their  extremities,  and 
the  longitudinal  depressions  on  their  sides,  mark  the  effort  to  form  three 
roots  for  the  tooth  of  the  upper  jaw,  and  two  for  the  lower,  according 
to  the  general  rule.  Owing  to  this  tooth  growing  at  the  posterior  ex- 
tremity of  the  alveolar  processes,  in  a  place  where,  from  the  preceding 
development  of  the  other  teeth,  it  is  much  cramped  for  room,  it  is  not 
only  imperfectly  evolved  in  most  cases,  but  it  often  takes  a  very  irre- 
gular direction ;  its  grinding  surface  sometimes  looking  forwards  and 
sometimes  backwards. 

The  Alveolar  Processes  in  each  jaw  form  a  semi-elliptical  row  of 
sockets,  for  the  insertion  of  the  roots  of  the  teeth  into  them.  These 
processes  and  the  teeth,  as  Mr.  Hunter  has  very  properly  explained, 
have  such  a  mutual  dependence  upon  each  other,  that  the  destruction 
of  the  one  is  inevitably  followed  by  that  of  the  other :  "  If  we  had  no 
teeth,  it  is  likely  we  should  not  only  have  no  sockets,  but  not  even  those 
processes  in  which  the  sockets  are  formed."1  The  semi-elliptical  ar- 
rangement observed  by  the  teeth  is  such,  that  when  the  mouth  is  closed, 
the  exterior  circumference  of  the  row  above  projects  beyond  that 
below ;  this  is  more  obviously  the  case  in  front ;  but  it  also  prevails  at 
the  sides,  and  depends  primarily  upon  the  greater  breadth  of  the  inci- 
sors of  the  upper  jaw.  The  grinding  surface  of  the  under  row,  as  a 
plate,  is  slightly  concave  from  before  backwards,  while  the  opposed 
surface  of  the  upper  row  has  a  corresponding  convexity.  Each  row, 
viewed  collectively,  forms  a  single  edge,  in  front;  but  after  having 
passed  the  cuspidati,  it  becomes  thicker,  forms  a  double  edge,  and  is 
continued  backwards  in  that  state. 

A  question  of  some  interest  has  recently  arisen  in  regard  to  the 
precise  apparatus  of  attachment  of  the  fangs  of  both  sets  of  teeth  to 
their  alveolar  cavities.  The  principal  cause  of  attachment  is  attri- 
buted to  a  distinct  ligament  or  fasciculus  for  each  tooth,  having  for 

!  Loc.  cit.  p.  7 . 


OF  THE  TEETH. 


463 


its  position  the  side  of  the  tooth  the  most  distant  from  the  front  line 
of  the  symphysis  of  the  jaw.  The  ligament  thus  situated  is  said  to 
arise  from  the  edge  of  the  alveolus  between  the  teeth,  and  proceeding 
forwards  in  the  case  of  the  molars,  and  inwards  in  the  case  of  the  in- 
cisors, to  be  inserted  into  the  neck  of  the  tooth  not  quite  the  sixteenth 
part  of  an  inch  from  the  enamel.  The  ligamentous  character  is  con- 
sidered as  very  distinct,  the  fibres  being  white  and  shining  like  tendon. 
The  exclusive  cutting  of  it  is  also  said  to  facilitate  very  much  the  ex- 
traction of  a  tooth.1 

My  own  observations,  made  upon  the  parts  softened  in  muriatic  acid, 
and  in  the  recent  state,  have  not  led  me  to  see  the  ligamentum  dentis 
in  so  distinct  a  light,  or  to  witness  the  extreme  facility  of  extraction 
after  it  alone  is  cut.  It  is,  however,  probable  that  the  insinuation  of 
an  instrument  between  the  tooth  and  alveolus  will  generally,  to  the  ex- 
tent of  the  incision,  diminish  the  force  of  resistance  in  pulling  the  tooth 
out.  The  actual  adhesion  of  the  tooth  to  the  alveolus  appears  to  me 
to  arise  from  the  original  capsules  of  the  tooth  being  converted  into  a 
single  layer  of  periosteum,  the  peri-odontal  membrane  (peri-odonteum), 
one  surface  of  which  adheres  to  the  alveolus,  and  the  other  to  the  fang 
of  the  tooth.  The  adhesion  I  have  found  particularly  strong  at  the 
margin  of  the  alveolus,  and  converging  circularly  from  it  to  the  neck 
of  the  tooth,  somewhat  in  the  manner  of  a  coronary  ligament.  Another 
subject  of  remark  is,  that  the  filaments  of  periosteum  are  not  laid  down 
laterally  to  the  teeth,  but  one  end  of  the  filament  adheres  to  the  alveo- 
lus, and  the  other  to  the  tooth,  like  the  filaments  of  the  interosseous 
ligament  at  the  lower  junction  of  the  tibia  and  fibula.  In  this  way  a 
cap  of  such  fibres  is  found  over  the  whole  fang  of  the  tooth  :  one  of  the 
best  means  of  demonstrating  it  is  to  chip  off  the  alveolus  in  front  of  a 
cuspate  tooth  of  the  lower  jaw,  then  seize  the  body  of  the  tooth  with  a 
pair  of  strong  pliers,  and  make  it  rotate  on  its  axis ;  the  fibres  will  thus 
be  seen  to  start  up  and  to  show  the  attachment  of  their  two  ends,  one 
to  the  alveolus,  and  the  other  to  the  tooth.  The  jaw  of  a  strong  mus- 
cular subject  is  especially  recommended.  This  arrangement  of  the 
course  of  the  fibres  is  very  well  exhibited  in  the  cow  and  horse. 


SECT.  II. — OF  THE  TEXTURE  AND  ORGANIZATION  OF  THE  TEETH. 

The  teeth  consist  in  three  kinds  of  substance,  one  of  which  is  Ena- 
mel, another  Ivory  or  Dentine,  and  the  third  Cortical  or  Bony,  also 
called  Cement. 

The  Enamel  forms  the  periphery  of  the  body  of  a  tooth,  and  is  dis- 
tinguished by  its  whiteness,  its  brittleness,  its  semi-transparency,  and  a 
hardness  so  considerable  that  it  soon  takes  down  the  edge  of  the  best 
tempered  saw  or  file,  so  that  it  is  very  difficult  to  penetrate  it.  It  forms 
a  crust  upon  the  body  scarcely  half  a  line  in  thickness,  is  more  abund- 
ant upon  the  grinding  surface,  and  is  reduced  to  a  thin  edge  where  it 

1  See  Description  of  the  Ligamentum  Dentis,  by  Paul  B.  Goddard,  M.  D.,  in  Am.  Journ. 
of  Med.  Sciences,  vol.  xxiii.  Phil.  1839. — Also  a  work  of  much  value,  the  Anal.  Physiol. 
and  Pathol.  of  the  Teeth,  parag.  144,  by  Paul  B.  Goddard,  M.D.,&c.,  and  Joseph  E.  Parker, 
Phil.  1844. 


464 


ORGANS   OF  DIGESTION. 
Fig.  142. 


A  view  of  an  Incisor  and  of  a  Molar  Tooth,  in  longitudinal  section.    1.  The  enamel.    2.  The  dentine. 
3.  The  pulp-cavity. 

terminates  at  the  neck.  When  broken,  it  is  seen  to  be  composed  of 
minute  hexagonal  or  four-sided  crystalline  columns  or  fibres,  ^^th  of 
an  inch  in  diameter,  and  the  fibres  are  so  placed  as  to  pass  in  a  direc- 
tion from  the  surface  towards  the  centre  of  the  tooth:  by  which  all  the 
friction  to  which  the  columns  are  exposed  is  applied  against  their  extre- 
mities :  an  arrangement  on  the  principle  of  the  articular  cartilages, 
and,  like  them,  precisely  suited  to  retard  their  being  rubbed  down  in 
mastication,  and  also  to  prevent  their  splitting. 

Fig.  143. 


Hexagonal  Prisms  of  Enamel,  highly  magnified,  from  the  exterior  part  of  the  enamel  of  an  embryo 
incisor  tooth.  Circular  outlines  were  seen  upon  the  free,  transversely  truncated  extremities,  which 
were  presumed  to  be  the  outline  of  the  nucleus. 

The  enamel  column  appears  to  be  formed  from  a  file  of  long  prismatic 
cells,  resembling  those  of  certain  shells,  and  having  a  diameter  of  ^g^^th 
of  an  inch.  Its  course  is  wavy,  and  marked  by  numerous  transverse 
striae,  thought  by  Retzius  to  come  from  the  coalition  of  the  walls  of 
pre-existing  cells,  in  forming  the  hexagonal  prism.  In  the  state  of  de- 
velopment there  appears  to  be,  according  to  the  observations  of  Dr. 
Leidy,  an  oblique  instead  of  a  rectangular  truncation  of  the  enamel 
fibre  at  these  striae.1 

Enamel  consists  principally  of  earthy  constituents,  with  a  very  small 


1  Leidy.  see  Quain  and  Sharpey,  vol.  ii.  p.  415. 


TEXTURE  AND  ORGANIZATION  OF  THE  TEETH. 


465 


proportion  of  gelatin.  When  immersed  in  a  weak  acid,  its  form  is  re- 
tained, but  the  slightest  disturbance  afterwards  causes  it  to  crumble 
down  into  a  white  pulp.'  When  animals  are  fed  upon  madder,  the  color 
of  the  enamel  is  not  affected  j1  though  it  may  be  changed  by  dyes  applied 
externally,  as  exhibited  by  the  inhabitants  of  the  Pelew  Islands,  who 
by  the  use  of  plants  turn  it  black,  and  by  persons  who  chew  tobacco, 
in  whom  it  becomes  yellow.  It  is  entirely  devoid  of  blood-vessels. 
When  exposed  to  heat  it  becomes  very  brittle,  cracks  off  from  the  en- 
closed part  of  the  body,  and  presents  a  singed  appearance,  notwith- 
standing the  small  quantity  of  gelatin  in  it. 

The  enamel  is  separated  from  the  ivory  by  an  extremely  fine  mem- 
brane, which  extends  its  processes  outwardly,  so  as  to  form  a  thin 
organic  sheath  for  each  enamel  fibre.  This  sheath  is  finally  obliterated 
or  nearly  so,  and  the  fibres  thus  consolidate. 

The  enamel  is  not  so  thick  on  the  deciduous  as  on  the  permanent 
teeth;  it  is  thicker  on  the  cuspidati  than  on  the  incisors,  and  on  the 
first  molar  than  on  the  second  and  third.  It  is  very  readily  dissolved 
in  strong  nitric  or  muriatic  acid. 

The  ivory  portion  of  the  tooth,  or  Dentine  (dentinum,  substantia 

Fig.  144. 


Fig.  144.  Magnified  representation,  or  rather  diagram,  of  a  Bicuspid  Tooth  divided  longitudinally. 
1.  The  ivory  or  dentine,  showing  the  direction  and  primary  curves  of  the  dental  tubuli.  2.  The  pulp- 
cavity,  showing  the  orifices  of  the  tubuli.  3.  The  crusta  petrosa  or  cemont  covering  the  fang  as  high 
as  the  border  of  the  enamel  at  the  neck.  The  stars  indicate  that  it  contains  lacunoe  like  those  of 
bone.  4.  The  enamel  resting  on  the  dentine. 

Fig.  145.  Section  of  the  Dentine  made  across  the  tubuli,  highly  magnified.  1,  2,  3.  Dentinal  tubes 
in  transverse  section,  exhibiting  their  cavity  and  walls.  4,  5,  6.  The  tubuli  obliquely  cut. 

1  J.  Hunter,  Inc.  cit.    1  have  also  verified  the  same  opinion  by  the  same  experiment. 
VOL.  I. — 30 


466  ORGANS  OF  DIGESTION. 

proprid),  is  by  much  the  most  abundant,  as  it  forms  the  root,  the  neck, 
and  the  body  also,  with  the  exception  of  the  crust  of  enamel  upon  it. 
Its  texture  strongly  resembles  the  petrous  bone,  and  is  even  harder 
than  it. 

When  the  dentine  or  ivory-like  part  of  a  tooth  is  examined  micro- 
scopically in  thin  slices,  it  is  found  to  be  permeated  by  slightly  bent 
cylindrical  tubuli,  close  to  one  another,  and  running  outwardly  to- 
wards the  surface  of  the  tooth.1  One  end,  and  the  larger  of  each 
canal  runs  into  the  cavity  of  the  tooth;  the  other  end  ramifies  with 
extreme  minuteness,  and  seems  to  penetrate  partially  the  enamel  and 
the  cement,  but  of  this  there  is  some  doubt.  The  dental  tubules  have 
distinct  parietes  in  the  midst  of  the  hard  substance  which  invests  them. 
Their  course  is  waved,  the  longer  curves  presenting  secondary  curva- 
tures. The  parallelism  and  nearness  of  the  tubules  give  to  the  den- 
tine, under  a  low  magnifying  power,  the  appearance  of  being  formed  of 
concentric  lamellae^  like  a  tree.  In  the  living  tooth  they  are  said  to 
contain  a  reddish  fluid,  but  they  are  too  small  for  blood-corpuscles,2  as 
their  diameter  at  the  central  end  is  only  the  j^^th  of  an  inch,  or 
__i5T_th,  according  to  Retzius,  while  their  ultimate  branches  are  too  fine 
for  any  measurement.  Their  outer  end  has  its  ramuscules  terminating 
free  or  else  by  anastomosis  with  others,  or  in  minute  cells,  or  by  small 
dilatations  from  which  other  ramuscules  depart.  Some  are  said  to 
reach  the  lacunae  of  the  crusta  petrosa.  The  minute  cells  of  the  dentine 
are  but  few  in  number,  and  exist  principally  near  the  enamel  in  a  stratum 
which  is  called  the  granular  layer  of  Purkinje.  The  tubules  serve  pro- 
bably for  the  conveyance  of  a  nutritious  fluid,  elaborated  from  the  blood 
of  the  pulp  of  the  tooth.  Miiller  and  Owen  are  of  opinion  that  they 
also  contain  calcareous  matter. 

The  dentine  of  a  tooth  has  very  nearly  the  same  form  with  the  en- 
tire body  ;  hence,  upon  the  grinding  surface,  we  have  the  same  modi- 
fications of  shape  as  when  the  enamel  is  left  on.  The  enamel  surface 
of  the  dentine  is  marked  by  undulating  grooves  and  ridges,  and  also 
by  hexagonal  depressions,  made  by  the  attachment  of  the  inner  end  of 
the  enamel  fibres.  The  application  of  a  heated  iron  to  it  turns  it  to  a 
deep  black,  from  the  abundance  of  animal  matter  in  it,  which  is  one 
way  to  mark  out  decidedly  the  distinction  between  it  and  enamel. 
The  animal  substance,  when  separated  from  the  calcareous  by  muriatic 
acid,  is  more  compact  than  the  corresponding  substance  of  bone,  but, 
like  it,  is  soft  and  flexible. 

The  dentine  is  not  vascular ;  Mr.  Hunter,  after  repeated  trials  in  old 
and  young  subjects  upon  this  point,  never  succeeded  in  making  an  in- 
jection of  it ;  neither  could  he  trace  vessels  from  the  pulp  to  a  grow- 
ing tooth.  In  growing  animals,  fed  upon  madder,  he  found  that  the 
portion  which  was  formed  previously  to  the  commencement  of  this  diet, 
retained  its  primitive  color,  while  the  part  formed  during  the  adminis- 
tration of  the  diet  was  affected  by  it  and  turned  red:  again,  if  the 
animal  were  permitted  to  live  some  weeks  after  the  madder  was  sus- 

1  Owen's  Odontography,  p.  iii.  London,  1841. 
*  Gerber,  Gen.  Anat.,  page  198. 


TEXTUEE  AND  ORGANIZATION  OF  THE  TEETH. 


467 


pended,  to  the  preceding  condition  was  superadded  a  new  layer  of 
white.  In  this  experiment,  a  conclusive  difference  from  common  bone 
is  established;  for  besides,  in  all  cases,  the  facility  of  injecting  the 
latter  with  size,  it  is  susceptible  of  being  dyed  throughout  by  the  ad- 
ministration of  madder ;  though  the  formed  parts  do  not  take  the 
latter  so  readily  as  the  forming.  These  experiments,  which  are  con- 
firmed by  my  own  observations,  prove  satisfactorily  the  total  absence 
of  blood-vessels  in  the  texture  of  the  dentine  ;  and  that  the  coloring 
matter,  when  fixed  in  them,  does  not  depend  upon  a  circulation,  but 
upon  its  being  deposited  as  the  tooth  grows,  and  left  there  permanent- 
ly. The  teeth  are  consequently  not  subjected  to  a  mutation  of  parti- 
cles, and  to  being  continually  remodelled  as  the  bones  are ;  but,  when 
once  formed,  they  remain  in  the  same  state,  without  change. 

The  Cement  (crusta  petrosa\  bony,  or  cortical  substance  is  an  enve- 
lop to  the  substantia  propria,  or  ivory,  and  extends  from  the  margin 
of  the  enamel  to  the  tip  of  the  fang.  Purkinje  and  others  have  traced 
it  as  a  thin  lamella  over  the  enamel,  but  it  soon  wears  away  there. 
There  seems  to  be  no  difference  between  it  and  common  bone,  and 
it  augments  in  quantity  as  life  advances ;  in  some  individuals  it  is  so 
exuberant  as  to  make  the  fangs  club-like.  In  the  ruminantia  it  forms 
stratifications  in  the  interior  of  the  teeth,  side  by  side  with  the  enamel. 
As  the  teeth  become  worn  in  the  progress  of  life  a  new  barrier  is  pre- 
sented against  the  exposure  of  the  cavity  by  the  deposit  in  it  of  this 
substance,  which  in  some  cases  fills  the  cavity  entirely.  It  undergoes 
there  some  modification  of  texture  called  osteo-dentine  by  Owen,  and 
which  permits  blood-vessels,  surrounded  by  Haversian  canals  as  in  bone. 

Under  the  microscope,  Purkinjean  or  bone-corpuscles  are  visible 
in  the  cement,  and  they  are  in  layers  concentrically  disposed,  but 
their  radiations  are  smaller  than  those  of  common  bone.  Gerber 
asserts,  that  it  is  furnished  with  a  few  blood-vessels  of  considerable 


Fig.  146. 


Fig.  146.  A  view  of  the  most  interior  portion  of  the  main  tubes  of  the  Dental  Bone  in  an  incisor  of 
a  child  two  years  old,  close  to  their  commencement  in  thecavitas  pulpae,  in  order  to  show  their  first 
division. 

Fig.  147.  A  view  of  the  external  portion  of  the  tubes  of  the  same  Tooth,  exhibiting  their  more 
minute  ramifications,  which  for  the  most  part,  turn  towards  the  crown. 


468  ORGANS  OF  DIGESTION. 

size,  which  run  from  the  root  outwards  and  towards  the  crown.  As 
his  comparative  and  human  anatomy  are  much  blended  in  his  de- 
scriptions, he  has  not  specified  whether  the  arrangement  exists  in  man 
or  not. 

According  to  Chemical  Analysis,  a  Tooth  consists  of  ingredients  in 
the  following  proportions: — 

Enamel,  by  Berzelius.  Dentine,  by  Berzelius. 

Phosphnte  and  Fluate  of  Lime,  88.5  64.3 

Carbonate  of  Lime,  8.00  5.3 

Phosphate  of  Magnesia,  1.5  1.0 

Free  Alkali,  1.00  0.0 

Animal  Matter  and  Water,  1.00  28.00 

Soda  and  Muriate  of  Soda,  0.0  1.4 

Cement,  according  to  Lassaigne. 

Phosphate  of  Lime,  53.84 

Carbonate  of  Lime,  3.98 

Animal  Matter,  42.18 

Every  tooth  has  within  its  body  a  cavity  (cavitas  pulpse),  which  varies 
in  form  and  size  according  to  the  class  to  which  the  tooth  belongs : 
this  cavity,  as  mentioned,  is  continued  as  a  conoidal  canal,  through  the 
whole  length  of  each  root,  and  terminates  by  a  small  opening,  at  its 
point  (see  Fig.  144).  The  cavity  is  smooth  on  its  internal  surface, 
and  is  filled  with  a  soft  pulpy  matter  (pulpa  dentis),  which  has  no 
adhesion  to  the  sides  of  the  tooth,  but  receives,  through  the  opening 
in  the  root,  ?n  artery,  a  vein,  and  a  nerve.  The  surface  of  the  pulp 
is  moistened  by  a  slight  exhalation,  and  its  principal  bulk  seems  to 
be  formed  by  the  nerve,  on  which  the  vessels  ramify ;  the  latter  in 
youth  are  much  more  abundant  than  in  old  age.2  The  base  of  each 
projection  on  the  grinding  surface  of  a  tooth  is  hollowed  out  for  re- 
ceiving a  process  from  the  pulp.  The  latter  is  supposed,  by  M.  Serres, 
to  be  a  ganglion;  it  must,  however,  be  a  point  of  much  difficulty  to 
fix  this  character  upon  it,  as  the  fine  cellular  substance  which  holds 
its  constituents  together  may  be  readily  mistaken  for  soft  nervous 
fibres.  The  nerves  are  said  by  Valentin  and  Hannover  to  end  in  looped 
filaments.  Acetic  acid  exposes  many  nuclei  in  the  pulp. 

The  arteries  of  the  teeth  of  the  upper  jaw  are  derived  from  the 
alveolar  and  the  infra-orbitar ;  and  the  nerves  from  the  second  branch 
of  the  fifth  pair.  The  arteries  of  the  teeth  of  the  lower  jaw  come 
from  a  single  branch  of  the  internal  maxillary,  and  the  nerves  from 
the  third  branch  of  the  fifth  pair.  The  inferior  maxillary,  or  dental 
artery,  and  nerve,  go  through  the  canal  in  the  centre  of  the  spongy 

1  The  analysis  of  Bibra  assigns  to  it  89.8  phosphate  oflime  with  traces  of  fluoride  of  cal- 
cium; 4.4  carbonate  of  lime;   1.3  phosphate  of  magnesia  and  other  salts,  and  3.5  of  ani- 
mal matter. 

2  Serres,  Essai  sur  TAnat.  et  Physiol.  des  Dents,  Paris,  1817. 


TEXTURE  AND  ORGANIZATION  OF  THE  TEETH.         4b'y 

structure  of  the  lower  jaw,  and  send  off  branches  successively  to  the 
roots  of  the  teeth.  The  residue  of  the  artery  and  nerve  issues  through 
the  anterior  mental  foramen. 

The  teeth  have  been  very  generally  ranged  among  the  bones  be- 
longing to  the  skeleton.  This  opinion,  nearly  at  one  time  obsolete, 
has  been  latterly  revived  by  the  researches  of  the  microscopical  ana- 
tomists,1 and  they  are  now  said  to  be  modified  or  epithelial  bones. 
The  opposite  authorities,2  now  perhaps  somewhat  disused  on  this 
point,  are  disposed  to  view  them  as  the  production  of  the  dermoid  tis- 
sue, like  the  nails  and  the  hair,  and  to  withdraw  them  from  the  class 
of  bones;  for  the  following  reasons.  The  rudiments  of  the  bones  are 
always  in  a  cartilaginous  state,  and  they  are  gradually  changed  from 
that  condition  to  the  perfect  bone;  the  teeth  are  never  so,  for  the  se- 
cretion which  forms  them  is  from  the  beginning  deposited  in  the  state 
in  which  it  ever  afterwards  remains.  The  bones  are  all  furnished  with 
a  periosteum ;  the  teeth  are  not  so  fully,  but  have  the  surfaces  of  their 
bodies  exposed  to  the  air.  The  general  softening  of  the  skeleton  which 
occurs  in  some  cases  of  rickets,  never  is  manifested  in  the  teeth.3  The 
texture  of  the  bones  is  penetrated  in  every  direction  with  blood-vessels, 
but  only  the  central  pulp  of  the  teeth  is  furnished  with  the  latter. 
The  teeth  are  composed  of  two  kinds  of  calcareous  matter,  one  osseous, 
the  other  enamel ;  the  bones,  on  the  contrary,  have  but  one.4  To  this 
we  may  add,  that  the  teeth  have  no  power  of  interstitial  growth  like 
the  bones.  It  is  also  said  by  naturalists  that,  in  mammiferous  animals, 
the  teeth  present  insensible  transitions  from  their  most  perfect  state  to 
a  lamellated  condition  resembling  horns  and  nails.5  Some  animals,  as 
the  shark,  have  the  teeth  only  adhering  to  the  gum  and  not  fixed  in 
sockets;  others  have  them  in  the  stomach;  both  of  which  circumstances 
serve  to  illustrate  still  farther  the  independence  of  the  teeth  upon  the 
osseous  system ;  and  that  their  being  fixed  in  sockets  belonging  to  the 
latter,  is  merely  a  collateral  and  not  an  essential  arrangement. 

In  irregular  dentition  in  the  human  subject,  teeth  are  sometimes 
found  growing  from  the  roof  of  the  mouth  without  a  direct  attachment 
to  the  bone ;  and  cases  occur  where  teeth  being  abandoned  by  the 
sockets,  take  a  transverse  horizontal  position  to  the  gum,  adhering 
only  to  it,  and  having  the  length  of  one  side,  the  upper  or  free,  ex- 
posed. In  the  anatomical  cabinet,  there  is  a  tooth  of  full  size,  having 
no  other  matrix,  but  an  encysted  ovarium.  These  instances  prove 
unequivocally,  the  intrinsic  independence  of  the  teeth  upon  the  skele- 
ton, whatever  may  be  the  analogies  of  composition  and  texture. 

1  Miescher,  Miiller,  Retzius,  Nasmyth,  Owen,  and  Gerber. 

2  J.  F.  Meckel,  Hipp.  Cloqnet,  Breschet,  Serres,  &c. 

3  There  is,  however,  a  species  of  brittleness  of  the  teeth,  in  which  their  strength  becomes 
about  that  of  pipe-clay. 

4  Serres,  loc.  cit. 

*  Traducteurs  de  J.  F.  Meckel,  Paris. 


470  ORGANS  OF  DIGESTION. 


SECTION  III. 

The  Gums  (gingivse)  are  a  continuation  of  the  lining  membrane  of 
the  mouth  over  the  alveolar  processes,  but  its  texture  there  is  much 
changed  ;  as  it  becomes  more  fibrous,  very  vascular,  and  loses  much  of 
its  sensibility  and  capability  of  being  extended.  As  the  gums  cover 
both  the  lingual  and  the  buccal  semi-circumference  of  the  alveolar  pro- 
cesses, they  adhere  very  closely  to  the  periosteum,  and  send  in  parti- 
tions through  the  interstices  between  the  teeth.  They  also  adhere 
tightly  to  the  neck  of  each  tooth,  so  that,  when  the  latter  is  drawn,  the 
gum,  unless  previously  detached,  is  apt  to  be  lacerated  ;  this  adhesion 
is  by  a  sort  of  rounded  or  partially  doubled  edge,  that  admits  of  a 
slight  degree  of  motion,  and  which,  from  its  thickness,  if  it  be  removed, 
by  ulceration  or  by  pressure,  causes  the  tooth  to  appear  to  project  un- 
naturally from  its  socket.  The  teeth,  from  being  united  to  the  jaw  by 
the  gum,  and  by  the  periosteum  continued  over  the  cavity  of  the  socket, 
have  preserved  to  them  that  degree  of  yielding  motion  which  prevents 
them,  on  their  unexpected  and  forcible  application  to  hard  bodies,  from 
being  fractured,  and  also  saves  their  sockets.1 


SECT.  IV. — OF  THE  EVOLUTION  OF  THE  TEETH. 

The  teeth,  before  they  protrude,  are  formed  in  the  interior  of  the 
maxillary  bones. 

Fig.  148. 


Part  of  lower  Maxilla  of  a  child,  containing  all  the  milk  teeth  of  the  right  side,  and  the  incisors  of 
the  left.  Sacs  and  pedicles  of  the  permanent  teeth  (except  the  wisdom  tooth),  exposed  by  removing 
part  of  the  bone  on  the  inside.  The  alveolar  canal  also  laid  open  to  show  the  course  of  the  nerve. 
The  large  sac  near  the  ramus  of  the  jaw  is  that  of  the  first  permanent  molar ;  and  above  and  behind  it, 
is  seen  the  commencing  rudiment  of  the  second  molar. 

In  that  condition,  their  matrix  or  rudimental  state  is  represented 
by  a  vascular  pulp,  surrounded  by  two  sacs,  an  external  and  an  internal 
one.  The  pulp  adheres  firmly  around  its  base  to  the  sacs,  and  is  the 
source  of  the  dentine. 

1  J.  Hunter,  loc.  cit.        / 


EVOLUTION  OF  THE  TEETH.  471 

The  External  sac  is  soft,  fibrous,  and  spongy,  and,  according  to 
Mr.  Hunter,  is  destitute  of  vessels.  It  lines  the  interior  of  the  socket, 
thereby  forming  its  periosteum  ;*  adheres  closely  by  its  deepest  end  to 
the  dental  nerves  and  blood-vessels,  and  by  its  superficial  one  to  the 
cartilaginous  thickening  which  exists  upon  the  margin  of  the  gums  of 
infants.  Fox,  Blake,  and  Meckel  consider  this  sac  vascular,  which  I 
think  more  probable,  from  its  being  a  continuation  of  the  periosteum, 
or  acting  as  such.  Mr.  Hunter  might,  therefore,  mean  that  it  was 
comparatively  destitute  of  vessels,  and  not  totally.  It  is  more  spongy, 
loose,  and  soft  than  the  internal  sac,  and  owing  to  its  adhesion  to 
the  gum,  may,  by  pulling  at  the  latter,  be  readily  drawn  out  entire 
with  all  its  contents.  The  Internal  sac  is  extremely  vascular,  and 
when  successfully  injected  appears  red  all  over ;  it  is  very  thin  and 
transparent,  and  was  considered  by  Bichat  as  a  serous  membrane.  The 
internal  sac,  at  its  region  next  to  the  gum,  has  a  pad  or  velvety  sur- 
face, the  source  of  the  enamel ;  and  at  the  other  end,  and  con- 
tiguous region,  a  granular  surface,  from  which  is  produced  the  cement. 
It  adheres  to  the  external  sac  where  the  latter  corresponds  with  the  gum  ; 
but  is  elsewhere  detached  from  it  with  the  exception  of  its  base,  where 
it  is  united  by  the  medium  of  the  vessels  that  penetrate  to  the  pulp, 
and  in  doing  so  it  obtains  its  extreme  vascularity  from  these  vessels. 
Between  it  and  the  pulp  there  is  a  mucilaginous  fluid  like  the  synovia 
of  the  joints,2  which  causes  the  internal  sac  to  protrude  like  a  hernia, 
if  a  small  puncture  be  made  through  the  parietes  of  the  external  one. 
The  internal  sac  forms  an  envelop  to  the  vessels  and  nerves  of  the 
pulp,  and  being  reflected  along  them,  terminates  by  adhering  to  the 
base  of  the  pulp.  When  the  tooth  protrudes  through  the  gum,  the 
capsule  thus  formed  by  the  two  sacs  is  perforated  at  its  summit ;  and 
wastes  away  like  the  gum,  till  the  body  of  the  tooth  is  sufficiently  ad- 
vanced. The  two  capsules,  which  are  then  to  be  considered  as  the  peri- 
osteum of  the  socket  and  of  the  root  of  the  tooth,  adhere  closely  to  the 
neck  of  the  latter  and  to  its  root.  These  sacs,  or  follicles,  as  they  are 
sometimes  called,  are  visible  in  the  tenth  week,  or  earlier,  of  uterine 
existence. 

The  Pulp,  or  germ  of  the  tooth  (pulpa  dentis)  is  a  very  vascular 
body,  and  adheres  to  the  socket  only  at  its  bottom,  where  the  vessels 
enter  ;  it  becomes  sufficiently  distinct  in  the  fourth  month  of  fcetal  ex- 
istence, and  rises  up  then  from  the  base  of  the  internal  membrane  of  the 
sac  like  a  small  simple  tubercle.  In  developing  itself  it  acquires  the  form 
peculiar  to  each  tooth,  and  is  actually  the  mould  for  it:  it  is  surrounded 
by  a  very  fine  vascular  web,  the  Membrana  preformativa  of  Purkinjd, 
which  is  detached  from  it  with  much  difficulty. 

The  Ossification  of  a  tooth  first  commences  on  that  surface  of  the 
pulp  next  to  the  gum,  by  one  or  more  points  according  to  the  number 
of  projections  which  the  future  tooth  is  to  have  on  its  grinding  surface. 
The  osseous  formation  in  its  very  early  stage  is  thin,  soft,  and  elastic, 
but  soon  acquires  a  hard  consistence.  The  incisors  begin  to  ossify  by 

1  Series,  loc.  cit.  *  Hunter,  loc.  cit. 


472  ORGANS   OF  DIGESTION. 

three  points,  the  cuspidatus  by  one,  the  bicuspis  by  two,  and  the  molaris 
by  three,  four  or  five.  The  several  points  of  ossification  continue  to 
increase  till  their  bases  come  into  contact;  they  then  coalesce,  and 
afterwards  the  tooth  grows  as  an  entire  body.  The  triturating  surface 
of  the  tooth  being  first  laid  after  this  manner,  a  formation  of  bone  then 
takes  place  along  its  edges,  till  the  body  of  the  tooth,  with  the  cavity 
in  the  centre,  is  completely  built  up.  In  this  progress,  it  gradually 
surrounds  the  pulp,  till  the  whole  of  the  latter,  excepting  its  base,  is 
covered  with  bone. 

The  adhesion  of  the  pulp  to  the  new-formed  bone  is  such  as  to  require 
some  slight  force  to  separate  them;  but  this  may  be  done  without  rup- 
turing materially  either  the  one  or  the  other ;  their  surfaces  which  were 
in  contact  are  smooth,  neither  is  there  any  evidence  of  a  vascular  com- 
munication between  them.1  The  line  of  the  strongest  adhesion  is  along 
the  latest  formed  edge  of  the  tooth,  and  that  results  from  the  exact 
apposition  of  the  pulp  and  it. 

The  crown  or  body  of  the  tooth  being  finally  finished,  its  base  is  some- 
what contracted,  and  thus  forms  the  neck  of  the  tooth.  In  the  subse- 
quent process  of  the  ossification  of  the  root,  the  number  of  the  latter  is 
predetermined  and  always  indicated  by  the  number  of  distinct  vessels 
and  nerves  which  go  to  the  pulp ;  there  are,  therefore,  three  roots  to 
the  upper  molares,  two  to  the  lower,  one  to  the  incisors,  and  so  on. 
When  the  root  is  fully  formed,  its  extremity  is  tapered  off  to  a  conoidal 
point ;  and  the  canal  or  hollow  in  it  containing  the  pulp  is  diminished 
to  a  proportionate  size,  so  that  being  also  conoidal,  its  external  end  ap- 
pears as  a  very  small  opening  not  large  enough  to  admit  a  bristle. 

"  Both  in  the  body  and  in  the  fang  of  a  growing  tooth,  the  extreme 
edge  of  the  ossification  is  so  thin,  transparent,  and  flexible,  that  it  would 
appear  to  be  horny  rather  than  bony,  very  much  like  the  mouth  or  edge 
of  the  shell  of  a  snail  when  it  is  growing ;  and,  indeed,  it  would  seem 
to  grow  much  in  the  same  manner,  and  the  ossified  part  of  a  tooth  would 
seem  to  have  much  the  same  connection  with  the  pulp  as  a  snail  has 
with  its  shell."2 

From  the  preceding  account,  it  is  clear  that  the  ivory  part  of  the 
tooth  is  formed  from  the  external  surface  of  the  pulp ;  consequently, 
that  the  external  lamina  of  the  crown  is  the  first  one  deposited,  and 
is  originally  of  the  size  which  it  ever  afterwards  retains;  and  that  the 
pulp  continues  this  elaboration  of  matter,  from  the  circumference  to  the 
centre,  until  the  tooth  (body,  neck,  and  root)  is  completely  formed. 
The  pulp,  during  this  process,  diminishes  continually  in  size,  but  elon- 
gates itself  at  the  same  time  towards  the  bottom  of  the  socket ;  or,  in 
the  words  of  Mr.  Hunter,  "is  lengthened  into  a  fang.'' 

As  the  fang  grows  in  length,  the  resistance  being  at  its  end,  causes 
the  tooth  to  rise  through  the  gum ;  the  socket,  in  the  mean  time,  has 
grasped  the  neck,  or  beginning  fang,  and,  being  modelled  upon  the  root, 
arises  with  it.  Mr.  Hunter's  experiments  on  animals,  interruptedly  fed 
on  madder,  led  him  to  believe,  that  the  ivory  part  of  a  tooth  is  formed 

1  Hunter,  Series,  Meckel,  loc.  cit. 

2  Hunter,  Nat.  Hist,  of  Human  Teeth,  p.  90. 


EVOLUTION  OF  THE  TEETH.  473 

of  lamellae,  one  placed  within  another;  that  the  outer  lamella,  being 
first  formed,  is  consequently  the  shortest,  and  that  the  internal  ones 
lengthen  successively;  this  appearance  is  now,  however,  attributed,  by 
Mr.  Owen,  to  the  secondary  curves  in  the  dental  tubules. 

In  the  formation  of  a  molar  tooth,  whep  the  body  is  finished,  ossifi- 
cations shoot  from  its  brim,  and  proceed  to  the  centre,  where,  by  their 
union,  they  form  the  commencement  of  two,  three,  or  occasionally  more 
roots.  Mr.  Hunter  says,  that  also  a  distinct  ossification  is  frequently 
found  upon  the  centre  of  the  base  of  the  pulp ;  and  two  or  more  pro- 
cesses, according  to  the  number  of  roots  to  be  formed,  proceed  to  join 
it  from  the  circumference  of  the  tooth;  and  in  this  way  the  fangs  of 
the  multiform  teeth  begin. 

The  formation  of  enamel  begins  shortly  'after  the  external  laminae  of 
the  bony  matter  commence  being  deposited.  This  material,  which  has 
its  mould  always  previously  formed  of  the  ivory  part,  comes  from  the 
velvety  pad  adhering  to  the  inner  face  of  the  internal  capsule.  The 
velvety  pad  or  pulp,  by  its  place  on  the  part  of  the  capsule  nearest  to 
the  gum,  faces  the  pulp  which  secretes  the  bone ;  whatever  eminences 
the  one  pulp  has,  the  other  has  the  same,  but  reversed,  so  that  they 
exactly  fit  upon  each  other.  This  pulp  is  best  seen  in  the  foetus  of  seven 
or  eight  months,  and  is  not  very  vascular;1  it  is  much  thinner  than  the 
other,  and  decreases  in  size  as  the  development  of  the  teeth  advances. 
That  which  belongs  to  the  incisor  teeth  is  in  contact  with  their  concave 
interior  surface,  but  in  the  molar  it  is  opposed  to  their  biting  surface.8 

"  In  the  graminivorous  animals,  such  as  the  horse,  cow,  &c.,  whose 
teeth  have  the  enamel  intermixed  with  the  bony  part,  and  whose  teeth, 
when  forming,  have  as  many  interstices  as  there  are  continuations  of 
the  enamel,  we  find  processes  from  the  (enamel)  pulp  passing  down  into 
those  interstices  as  far  as  the  pulp  which  the  (bony)  tooth  is  formed 
from,  and  there  coming  into  contact  with  it. 

"  The  enamel  appears  to  be  secreted  from  the  pulp  above  described, 
and  perhaps  from  the  capsula  which  encloses  the  body  of  the  tooth. 
That  it  is  from  the  pulp  and  capsula,  seems  evident  in  the  horse,  ass, 
ox,  sheep,  &c. ;  therefore,  we  have  little  reason  to  doubt  of  it  in  the 
human  species.  It  is  a  calcareous  earth,  probably  dissolved  in  the  juices 
of  our  body,  and  thrown  out  from  these  parts,  which  act  here  as  a  gland. 
After  it  is  secreted,  the  earth  is  attracted  by  the  bony  part  of  the  tooth, 
which  is  already  formed;  and  upon  that  surface  it  crystallizes. 

"  The  operation  is  similar  to  the  formation  of  the  shell  of  the  egg, 
the  stone  in  the  kidneys  and  bladder,  and  the  gall  stone.  This  accounts 
for  the  striated  crystallized  appearance  which  the  enamel  has  when 
broken,  and  also  for  the  direction  of  these  striae. 

"  The  enamel  is  thicker  at  the  points  and  bases  than  at  the  neck  of 
the  teeth,  which  may  be  easily  accounted  for  from  its  manner  of  forma- 
tion ;  for  if  we  suppose  it  to  be  always  secreting  and  laid  equally  over 
the  whole  surface,  as  the  tooth  grows,  the  first  formed  will  be  the 
thickest;  and  the  neck  of  the  tooth,  which  is  the  last  formed  part  en- 
closed in  this  capsula,  must  have  the  thinnest  coat ;  and  the  fang  where 

1  Owen  denies  that  it  has  any  capillaries. 

2  Hunter,  loc.  cit. 


474  ORGANS  OF  DIGESTION. 

the  periosteum  adheres,  and  leaves  no  vacant  space,  will  have  none  of 
the  enamel. 

"  At  its  first  formation  it  is  not  very  hard,  for,  by  exposing  a  very 
young  tooth  to  the  air,  the  enamel  cracks  and  looks  rough;  but  by 
the  time  that  the  teeth  cut  the  gum,  the  enamel  seems  to  be  as  hard 
as  ever  it  is  afterwards ;  so  that  the  air  seems  to  have  no  effect  in 
hardening  it." 

The  preceding  passages  have  been  extracted  literally  from  the  cele- 
brated J.  Hunter's  Natural  History  of  the  Human  Teeth,  not  only  on 
account  of  their  graphical  value,  but  to  fix  upon  him  the  merit  of  hav- 
ing first  considered  the  human  teeth  as  a  secretion ;  an  opinion  the 
originality  of  which  is  falsely  attributed  to  the  Baron  Cuvier,  by  M. 
Serres.1 

In  opposition  to  this,  which  is  now  called  the  Excretion  Theory,  there 
is  presented  the  Conversion  Theory  founded  upon  the  recent  observa- 
tions of  Schwann,  Purkinje',  Raschkow  and  of  Owen.  Under  the 
latter  doctrine  we  have  to  view  the  Dentine  as  formed  from  the  real 
conversion  of  the  pulp,  by  the  pulp  being  actually  calcified,  after  the 
manner  of  bone  cartilage.  The  pulp,  to  produce  this  result,  must  of 
course  undergo  a  continued  growth  and  series  of  metamorphoses,  which 
are  explained  as  follows.  The  pulp  consisting,  as  it  does,  of  minute 
nucleated  cells,  with  capillary  blood-vessels  and  nerves  terminating  in 
loops,  is  invested  by  a  dense  structureless  membrane  (membrana  pre- 
formativd)  which  disappears  during  the  formation  of  the  dentine.  The 
peripheral  cells  are  elongated  in  a  line  with  the  dental  tubules,  and  are 
found  by  the  microscope  in  a  state  of  transition  into  dentine;  when  the 
pulp  and  the  surrounding  surface  of  dentine  are  forced  apart,  these 
transition  cells  are  found  adhering  to  the  latter. 

According  to  Prof.  Owen,  the  first  calcification  takes  place  in  the 
interior  of  the  nucleated  cells,  and  about  their  nuclei,  which  are  split 
up  and  form  by  their  elongation  a  connection  with  the  nuclei  in  advance 
of  them.  The  divided  nuclei  become  secondary  cells,  and  being  placed 
in  files  or  rows,  remain  uncalcified,  and  constitute  the  tubuli  of  the  den- 
tine. The  sum  of  this  theory,  then,  is  that  the  dentine  consists  of  the 
calcified  cells  of  the  pulp — and  the  tubules  are  the  nuclei  uncalcified, 
and  which  have  formed  a  linear  connection  with  one  another. 

Upon  detaching  a  layer  of  the  calcified  cells,  the  exposed  surface  of 
uncalcified  pulp  resembles  a  net-work,  the  meshes  of  which  are  formed 
by  the  cells  themselves  and  by  the  intervening  blastema.  Each  mesh 
is  filled  by  a  finer  net-work,  the  centre  of  each  loop  of  which  was  con- 
tinuous with  the  tubules  of  the  dentinal  substance.2 

The  matrix  or  pad  of  the  internal  capsule,  from  which  originates  the 
enamel,  is  at  first  in  a  more  fluid  state  in  regard  to  its  blastema,  and 
has  fewer  and  more  minute  cells,  but  in  progressing  towards  the  den- 
tinal pulp  it  acquires  more  consistence;  and  has  cells  of  augmented 
volume,  some  of  which  have  a  nucleus  and  even  a  nucleolus.  The  free 
surface  of  this  structure  is  coated  by  a  fine  transparent  membrane,  upon 
which  rests  a  thick  stratum  of  nucleated  cells,  composing  the  enamel 

1  Anat.  et  Phys.  des  Dents,  p.  63.  *  Odontography. 


EVOLUTION  OF  THE  TEETH.  475 

membrane  (membrana  adamantina).  The  vascular  part  of  the  enamel 
pulp  sends  forward  villous  processes  containing  blood-vessels,  which 
project  into  the  enamel  membrane  opposite  the  grinding  surface  of  the 
tooth.  The  cells  by  mutual  pressure  are  elongated  and  forced  into 
hexagonal  and  polygonal  forms,  the  blastema  between  them  being  almost 
excluded.  The  cells  finally  lose  all  trace  of  nucleus  and  become  elon- 
gated prismatic  filaments,  which  imbibe  the  calcareous  matter  from  the 
blastema,  and  form  themselves  into  a  clear  and  almost  crystalline  state 
in  their  interior.  As  a  final  action,  the  membranous  walls  of  the  cells 
disappear,  except  next  to  the  enamel  pulp.  In  opposition  to  the  re- 
puted vascularity  of  the  enamel  membrane,  Mr.  Owen  says  that  no  capil- 
laries exist  in  the  enamel  pulp,  the  cells  of  the  latter  must,  therefore, 
have  an  inherent  power  of  their  own  in  producing  such  changes,  by  a 
selection  of  material  from  the  internal  capsule  of  the  dental  sac.1 

The  transverse  strise  of  the  human  enamel,  it  is  suggested  by  Prof. 
Owen,  are  due  to  the  remains  of  nucleoli. 

The  matrix  of  the  Cement  or  Crusta  Petrosa  of  the  tooth  consists 
of  a  granular  blastema  upon  the  interior  face  of  the  inner  dental  cap- 
sule ;  this  matrix  is  furnished,  according  to  Mr.  Owen,  with  nucleated 
cells,  and  copiously  supplied  with  blood-vessels.  The  process  of  calci- 
fication begins  on  its  free  surface  next  to  the  dentine,  and  consists  in 
the  introduction  of  calcareous  matter  into  the  cavities  of  the  cells,  and 
in  their  closest  aggregation.  The  newly-formed  cement  presents  on  its 
surface  small  depressions  made  by  the  contiguous  unossified  cells.  The 
nucleus  of  a  cell  is  large,  granular,  and  almost  fills  the  area  of  the  cell, 
and  as  the  process  of  calcification  advances,  the  nucleus,  not  participat- 
ing in  the  latter,  sends  out  radiating  prolongations.  This  disposition 
of  the  nuclei,  when  the  latter  are  removed,  causes  the  microscopic  ana- 
logies as  to  the  corpuscles  of  Purkinje'  between  bone  and  cement. 

In  infants,  for  several  months  after  birth,  the  biting  margin  of  the 
gums  upon  each  jaw  is  faced  by  a  cartilaginous  rising  of  some  lines  in 
elevation,  and  divided  by  slight  fissures.  Its  usual  appellation  is  that 
of  Dental  Cartilage  (cartilago-dentalis)',  it  performs  the  function  of 
teeth,  in  retaining  the  nipple,  and  in  mastication,  and  is  analogous  to 
the  horny  beak  of  birds,  and  of  some  reptiles  ;  it  only  disappears  upon 
the  protrusion  of  the  teeth.  In  the  upper  jaw  it  is  about  three  lines 
wide,  and  in  the  lower  about  two.  If  it  be  removed  by  thin  slices,  suc- 
cessively made,  till  the  margins  of  the  alveoli  appear,  one  arrives  by  that 
means  at  the  ends  of  the  dental  follicles  or  sacs;  from  which  it  appears 
that  there  is  no  intermediate  substance. 

In  the  preceding  cartilage  are  found  many  small  glands,  grouped 
about  in  different  parts  of  it.  They  were  discovered  by  M.  Serres,2  of 
Paris ;  are  about  the  size  of  a  millet  seed,  contain  a  whitish  fluid,  and 
when  examined  by  the  aid  of  a  microscope  do  not  appear  to  have  any 
distinct  opening  or  duct,  in  consequence  of  which  they  must  be  punc- 
tured in  order  to  expel  their  contents.  The  largest  of  them  are  on  the 
internal  side  of  the  gum  near  the  molar  teeth. 

1  Odontography.  2  LOG.  cit. 


476  ORGANS  OF  DIGESTION. 

According  to  their  discoverer,  these  glands  serve  to  lubricate  the 
dental  cartilages  of  the  infant,  but  after  the  protrusion  of  the  teeth  they 
secrete  the  substance  commonly  called  tartar,  and  heretofore  falsely 
attributed  to  the  saliva.  Their  secretion  being  of  a  fatty  nature,  keeps 
up  the  high  and  brilliant  polish  which  the  teeth  have  till  middle  age ;  it 
being  afterwards  altered,  the  teeth  then  become  more  dull  and  yellow. 
Salivation  produces  an  excessive  secretion  and  deposit  of  tartar  from 
these  glands.  J.  F.  Meckel  states  that  he  has  never  been  able  to  dis- 
cover them  till  towards  the  period  of  dentition,  from  which  he  is  rather 
induced  to  consider  them  as  a  morbid  production  depending  upon  irri- 
tation, and  probably  not  differing  from  little  abscesses. 

According  to  Mr.  Mandl,  the  tartar,  heretofore  considered  as  a  sim- 
ple calcareous  concretion  deposited  on  the  teeth,  is  a  mass  of  calcareous 
skeletons  of  Infusoria,  agglutinated  by  dried  mucus.  The  animals  are 
of  the  description  called  Vibrios,  and  are  formed  in  a  living  state  in 
the  mucus  of  the  mouth,  especially  after  fasting,  They  are  said  to  make 
a  large  part  of  the  mucous  covering  of  the  tongue  in  dyspepsia. 


SECT.  V. — PHENOMENA  OF  DENTITION. 

Infants  have  a  set  of  teeth  called  Deciduous,  from  their  being  lost 
after  a  certain  period  of  time.  Their  whole  number  is  twenty,  ten  in 
each  jaw,  consisting  on  either  side  of  two  incisors;  one  cuspidatus; 
and  two  molares,  having  a  shape  corresponding  with  that  of  the  large 
grinders  in  the  adult.  Several  of  these  teeth  fall  out  about  the  seventh 
year,  and  all  of  them  have  disappeared  about  the  fourteenth.  The 
time  of  their  first  protrusion  through  the  gums  is  variable,  but  may, 
as  a  general  rule,  be  stated  at  from  the  sixth  to  the  eighth  month  after 
birth.  They  appear  commonly  in  pairs.  The  pairs  of  the  lower  jaw 
have  precedence  in  their  protrusion ;  and  are  immediately  followed, 
successively,  by  their  congeners  in  the  upper.  The  order  of  protrusion 
is  as  follows : — 

The  two  central  incisors,  from  the  sixth  to  the  eighth  month ; 

The  two  lateral  incisors,  from  the  seventh  to  the  tenth  month ; 

The  first  molar  tooth,  on  each  side,  from  the  twelfth  to  the  fourteenth 
month ; 

The  cuspated,  from  the  fifteenth  to  the  twentieth  month ; 

The  second  molar,  on  each  side,  from  the  twentieth  to  the  thirtieth 
month.1 

The  average  time  may  be  stated  as  follows : — 

Central  incisors,  seventh  month; 

Lateral  incisors,  ninth  month; 

First  molar,  twelfth  month; 

Cuspate,  eighteenth  month; 

Second  molar,  twenty-fourth  month. 

The  Deciduous  teeth,  by  a  process  which  will  be  presently  explained, 
drop  from  the  gums  and  are  succeeded  by  the  permanent  teeth.  The 

1  Series,  loc.  cit. 


DENTITION.  477 

first  permanent  molar,  by  emerging  behind  the  second  infant  molar,  at 
about  six  or  seven  years  of  age,  leads  the  way  to  the  second  epoch  of 
dentition  which  occurs  in  the  following  order: — 

The  central  infant  incisors  fall  out  about  the  sixth  or  seventh  year, 
and  are  immediately  followed  by  the  central  permanent  incisors; 

In  a  few  months  afterwards,  sometimes  at  the  same  period,  the 
lateral  infant  incisors  tumble  out,  and  are  succeeded  by  the  lateral 
permanent  incisors; 

About  the  ninth  year  the  first  molar  teeth  fall  out,  and  are  succeeded 
by  the  first  bicuspated  ; 

From  the  ninth  to  the  eleventh  year  the  second  molars  fall  out,  to 
be  succeeded  by  the  second  bicuspated; 

From  the  eleventh  to  the  twelfth,  the  infant  cuspated  are  followed 
by  the  adult  cuspated  ; 

About  the  end  of  the  twelfth  year,  the  second  permanent  molars 
protrude  behind  the  first  permanent ; 

And,  finally,  about  the  twenty-first,  or  in  cases  from  the  sixteenth 
to  the  twenty-fifth  year,  the  third  permanent  molars,  or  the  Dentes 
Sapientiae,  make  their  appearance. 

In  the  jaw  of  a  foetus  of  three  or  four  months  after  conception,  the 
beginning  of  the  alveolar  processes  may  be  observed,  in  the  condition 
of  a  longitudinal  groove,  deeper  and  more  narrow  in  front,  more  shal- 
low and  wider  behind;  and  in  the  bottom  of  the  groove  are  small  trans- 
verse ridges,  dividing  it  into  superficial  depressions.  From  this  simple 
condition,  ridges  begin  to  shoot  out  from  the  opposite  sides  of  the  canal 
near  its  brim;  and  form,  by  their  junction,  arches  across  it;  more 
matter  being  added  to  these  arches,  they  make,  in  their  progress,  a 
sort  of  cell  for  each  tooth,  open  on  its  alveolar  surface.  This  open- 
ing is  nearer  the  internal  circumference  of  the  alveolar  processes, 
so  that  the  teeth  are  almost  covered,  and  probably  for  the  reason  ad- 
vanced by  Mr.  Hunter,  that  the  gums  may  be  firmly  supported  before 
the  teeth  come  through. 

The  rudiments  of  the  teeth  which  are  earliest  in  their  appearance 
may  be  readily  found  in  a  foetus  of  two  or  two  and  a  half  months ;  and 
at  the  expiration  of  three  months,  it  is  said  that  all  the  germs  of  both 
sets  of  teeth  exist  in  a  manner  to  be  distinguished.1  The  germs  of  this 
period  are  lodged  in  membranous  folds  belonging  to  the  gum.  The 
germs  of  the  first  dentition  are  immediately  attached  to  the  gum,  while 
those  of  the  second  are  suspended  by  pedicles  or  gubernacula  of  a  line 
or  two  in  length,  which  circumstance  alone  permits  them  to  be  distin- 
guished. At  four  months  all  the  germs  are  contiguous  to  each  other, 
with  the  exception  of  the  incisors ;  shortly  afterwards  they  begin  to 
be  separated  by  the  rudiments  of  the  alveolar  processes ;  and  about 
the  fifth  month  ossification  is  perceptible  in  the  infant  incisors,  and 
goes  on  in  the  other  teeth  very  much  in  the  order  of  their  appearance. 

The  germs  of  the  deciduous  teeth  are  placed  in  an  arc  of  a  circle, 
the  cuspidati  being  thrown  forwards  out  of  the  line  of  the  others  and 

.   !  Serres,p.  3. 


478  ORGANS  OP  DIGESTION. 

somewhat  lower ;  in  consequence  of  which,  the  small  molar  or  bicuspate 
border  closely  upon  the  incisors.  The  germs  of  the  permanent  teeth 
are  brought  into  view  by  removing  the  internal  face  of  the  jaw,  and 
are  at  the  posterior  upper  side  of  the  first  germ,  being,  therefore, 
nearer  to  the  edges  of  the  alveolar  processes. 

The  matrix  or  rudiments  of  the  permanent  tooth  are,  according  to 
Meckel,  the  offset  from  the  corresponding  deciduous  tooth. 

At  birth,  ossification  has  taken  place  in  all  the  infant  teeth,  though 
their  roots  are  not  yet  completed.  The  rudiments  of  the  permanent 
teeth,  though  seen  at  an  early  period  of  foetal  existence,  do  not  begin 
to  ossify  till  after  birth.  Thus,  the  first  adult  incisor  and  molar  begin 
to  ossify  about  the  fifth  or  sixth  month  of  life,  the  second  incisor  and 
cuspidatus  about  the  ninth  month,  the  first  bicuspis  about  the  fifth  year, 
the  second  bicuspis  and  second  molar  about  the  sixth  or  seventh,  and 
the  third  molar  about  the  twelfth  year.1 

The  preparation  for  the  evolution  of  the  teeth,  according  to  the  ob- 
servations of  Mr.  Goodsir,2  is  visible  at  the  sixth  week  of  foetal  life,  in 
the  upper  jaw  by  a  deep  narrow  groove  which  is  speedily  divided  into 
two  by  a  narrow  ridge.  The  outer  groove  is  to  become  in  progress  of 
time  the  outer  alveolar  processes;  while  the  inner  groove  is  the  nidus 
for  the  evolution  of  the  teeth.  In  the  seventh  week  a  small  ovoidal 
papilla  of  granular  matter,  the  rudiment  of  the  first  milk  molar,  is  seen : 
in  the  eighth  week  a  similar  evolution  for  the  canine  takes  place;  in 
the  ninth  week  the  process  is  repeated  for  the  incisors,,  and  in  the  tenth 
week  for  the  second  milk  molar.  The  sacs  or  follicles  of  the  teeth  are 
formed  originally  by  processes  crossing  the  dental  groove  and  finally 
coalescing  so  as  to  cover  in  and  around  the  papilla.  In  the  thirteenth 
week  the  rudiments  consist  evidently  of  a  vascular  pulpy  substance, 
and  is  surrounded  by  a  double  capsule.  This  Mr.  Goodsir  calls  the 
follicular  stage,  and  is  completed  in  the  fourteenth  week. 

In  the  fourteenth  or  fifteenth  week  the  original  dental  groove  is  raised 
to  a  higher  level  than  before;  that  is  to  say,  deepened,  and  in  that  state 
being  called  the  secondary  dental  groove,  it  gives  origin  to  the  second  set 
of  teeth  by  the  evolution  of  small  compressed  sacs  between  the  gum  and 
the  first  set  of  germs,  to  the  follicles  of  which  they  adhere  by  a  species 
of  gemmiparous  attachment.  There  are  stages  of  evolution  and  trans- 
position from  this  period  to  the  perfect  state  of  dentition3  which  are  too 
much  in  detail  to  be  inserted  here,  but  which  may  be  advantageously 
studied  in  the  paper  alluded  to. 

The  observations  of  Mr.  Goodsir  have,  in  many  respects,  been  essen- 
tially confirmed  by  Professor  Owen,  in  his  celebrated  work.4  The  latter 
says,  that  the  first  papilla  may  be  distinctly  recognized  in  the  maxillary 
mucous  groove  of  a  human  embryo  of  one  inch  in  length.  This  papilla 
or  dentinal  pulp  is  the  first  developed  part  of  the  rudiment  or  matrix, 
and  by  the  growth  of  the  contiguous  mucous  membrane,  has  a  sort  of 
follicle  formed  around  it,  the  orifice  of  which  is  finally  closed  by  three 

1  Hunter,  loc.  cit. 

3  On  the  Origin,  &c.,  of  the  Human  Teeth,  Edinburgh  Med.  and  Surg.  Journal,  January, 
1839.     See,  also,  Principles  of  Human  Physiology,  by  W.  B.  Carpenter.     London,  1842. 

»  Ibid.,  Quain  and  Slmrpey,  Anat.  Phila.  1849. 

4  Odontography,  London,  1840. 


DENTITION.  479 

or  four  lamellar  plates  forming  an  operculum.  Upon  the  interior  face 
of  these  plates,  and  upon  the  adjoining  region  of  the  capsule  or  follicle, 
the  enamel  pulp  is  developed  at  the  sixteenth  week. 

As  the  permanent  teeth  are  preparing  to  protrude,  the  alveolar  cavi- 
ties, in  which  they  are  contained,  form  orifices  on  the  internal  surface 
of  the  jaw  near  the  edges  of  the  deciduous  alveolar  processes,  and  which 
are  called  the  Alveolo-dental  Canals  (itinera  dentium).  Those  for  the 
incisor  and  canine  teeth  are  just  behind  their  corresponding  deciduous 
teeth,  and  those  for  the  bicuspated  near  and  somewhat  behind  the  infant 
molares.  At  this  period,  a  bony  septum  separates  almost  completely 
the  two  orders  of  alveolar  cavities  from  each  other,  and  thereby  pre- 
vents their  mutual  interference  or  communicating. 

The  teeth  which  have  no  predecessors  are,  in  consequence  of  their 
adhesion  to  the  gum,  brought  out  in  their  regular- places;  but,  in  the 
case  of  such  permanent  teeth  as  take  the  position  occupied  by  the  deci- 
duous, there  is,  before  the  tooth  protrudes,  the  pedicle  already  alluded 
to  (gubernaculum  dentis),  which  passes  from  the  alveolar  end  of  the 
sac  of  the  permanent  tooth  to  the  sac  of  the  deciduous  tooth  ;  and  even 
when  the  latter  is  fully  formed  and  protruded,  the  same  pedicle  may  be 
traced  to  that  part  of  the  gum  surrounding  the  neck  of  the  deciduous 
tooth.1  At  birth,  the  rudiments  of  fifty-two  teeth  may  be  found  in  the 
two  jaws;  and,  as  a  general  rule  at  that  period,  the  rudiments  of  the 
permanent  are  more  superficial  than  those  of  the  deciduous ;  but  their 
position  is  subsequently  changed,  so  that  the  first  descend  while  the 
latter  ascend. 

The  permanent  teeth  being  thus  formed  in  new  and  distinct  sockets, 
and  being  kept  off  from  the  deciduous,  it  is  clear  that  the  latter  cannot 
be  pushed  upwards  out  of  their  alveoli,  as  is  sometimes  supposed,  by 
the  growth  of  the  former  ;  and  if  it  did  take  place,  it  would  produce  the 
great  inconvenience  of  causing  them  to  rise  up  into  the  mouth,  beyond 
the  level  of  the  other  teeth.  On  the  contrary,  the  deciduous  teeth  are 
made  loose  by  the  removal  of  their  roots,  which  progresses  till  nothing 
but  the  neck  is  left,  and  then  the  slightest  force  applied  dislodges  them 
from  their  position  on  the  gum.  This  decay  of  the  root  is  not  even 
affected,  according  to  Mr.  Hunter,  by  the  pressure  of  the  rising  tooth, 
for  the  new  alveoli  rise  with  the  new  teeth,  and  the  old  ones  decay 
along  with  their  decaying  fangs ;  and  when  the  first  set  falls  out,  the 
succeeding  teeth  are  enclosed  by  a  complete  bony  socket ;  from  which 
it  is  evident  that  the  change  is  not  produced  by  mechanical  pressure, 
but  is  a  particular  process  in  the  animal  economy.3  In  farther  proof, 
however,  Mr.  Hunter  has  seen  two  or  three  jaws  where  the  second  de- 
ciduous molars  were  shedding  by  the  decay  of  their  roots,  without  there 
being  underneath  any  tooth  to  press  upon  them;  and  in  another  jaw  he 
observed  the  same  circumstance  in  both  molars  on  each  side.  In  a 
female  patient,  in  whom  the  last  temporary  molar  was  loose,  and  was 
pulled  out  in  consequence,  it  was  not  succeeded  by  another  tooth.  One 
of  these  patients  at  the  time  was  aged  twenty,  and  the  other  thirty; 

1  Cloquet,  Anat.  Pi.  XXII.  fig.  16,  17.     Serres,  loc.  cit.  p.  109. 

2  Serres,  loc.  cit. 

3  Hunter,  loc.  cit. 


480  ORGANS  OF  DIGESTION. 

from  which  it  would  appear,  that  though  the  wasting  of  a  fang  of  a  de- 
ciduous tooth  does  not  depend  upon  the  pressure  of  the  permanent  one, 
yet  the  latter  determines,  in  some  measure,  its  expulsion,  as  without 
some  such  influence,  the  period  of  shedding  would  not  have  been  so  late. 

From  these  observations  of  Mr.  Hunter,  it  is  established  that  the 
pressure  of  the  permanent  tooth  is  not  indispensable  to  the  removal  of 
the  deciduous  one  in  all  cases  ;  yet  I  think  it  will  be  most  frequently 
found  that  much  of  the  decay  of  the  root  of  the  deciduous  tooth  is  owing 
to  its  being  absorbed  by  the  pressure  of  the  body  of  the  permanent  one. 
The  alveoli  of  the  latter  teeth,  judging  from  my  own  observations,  are 
seldom  so  perfect  towards  the  period  of  their  protrusion  as  to  form  a 
complete  separation  of  the  two  orders  of  teeth.  And  even  when  the 
alveoli  are  perfect,  the  permanent  tooth  is  made  to  press  upon  the  root 
of  the  deciduous  tooth  by  the  evolution  of  the  body  of  the  permanent, 
of  which  pressure  the  root  of  the  deciduous  exhibits  ample  evidence. 

Besides  the  deciduous  teeth  being  loosened,  as  stated  by  Mr.  Hunter, 
by  the  absorption  of  their  alveolar  cavities  while  the  fangs  are  dis- 
appearing, the  following  process  occurs.  The  permanent  teeth  protrude 
within  the  circle  of  the  deciduous,  the  arch  of  the  latter  is  weakened, 
and  its  several  pieces  are  in  that  way  detached  by  a  force  acting  from 
within  outwards  :  this  influence  being  much  assisted  by  the  wasting  of 
the  alveolar  cavities,  which  proceeds  principally  at  their  outer  circum- 
ference. The  latter,  however,  is  not  so  obviously  the  case  with  the 
ijiolar  as  with  the  incisive  and  canine  teeth. 

The  deciduous  teeth,  even  before  they  are  loosened  by  the  absorp- 
tion of  their  fangs  and  of  their  alveolar  processes,  are  much  more  easily 
extracted  in  proportion  than  the  adult  teeth,  from  the  texture  of  their 
periosteum  being  much  softer  and  more  yielding. 

In  the  lower  jaw  of  the  adult  there  is  but  one  arterial  trunk,  which 
supplies  the  teeth ;  but,  in  the  fetus,  and  till  the  age  of  six  or  seven 
years,  there  are  two  arteries,1  and  as  many  canals  for  containing  them. 
The  lowest  of  these  arteries  belongs,  exclusively,  to  the  deciduous  teeth  ; 
it  i»s  distinctly  visible  in  the  foetus,  augments  till  the  third  or  fourth 
year,  afterwards  it  shrinks,  and  is  obliterated  about'the  sixth  or  seventh 
year.  In  some  rare  cases  its  canal  remains  open  for  a  longer  time,  as 
M.  Serres  has  met  with  it  in  a  woman  of  thirty.  Being  a  branch  from 
the  inferior  maxillary,  it  enters  the  bone  at  a  foramen  somewhat  lower 
down  than  the  posterior  maxillary  or  mental ;  and  what  remains  of  it 
after  the  teeth  are  supplied  comes  out  at  another  aperture,  a  little 
below  the  anterior  maxillary  foramen,  and  there  anastomoses  with  the 
other  dental  artery. 

M.  Serres  supposes  that  this  artery,  discovered  by  himself,  and  ob- 
viously serving  in  the  evolution  of  the  deciduous  teeth;  by  being  obli- 
terated before  they  fall  out,  destroys  their  vitality,  and,  thereby,  they 
become  absolutely  foreign  bodies,  the  expulsion  of  which  is  required  by 
nature  on  common  principles. 

1  Serres,  loc.  cit.  p.  17. 


IRREGULARITIES  IN  DENTITION.  481 


SECT.  VI. — OF  IRREGULARITIES  IN  DENTITION. 

This  process  in  certain  individuals  is  premature ;  Louis  XIV.  was 
born  with  two  teeth ;  many  instances  of  the  same  sort  of  precocity  are 
recorded  by  Haller  and  other  medical  writers,  in  some  of  which  even 
ten  teeth  were  found  protruded  at  birth. 

On  other  occasions,  the  process  is  retarded  in  a  manner  equally  strik- 
ing, and  varying  from  the  tenth  month  to  the  sixth  or  seventh  year. 
This  unusual  tardiness  is  sometimes  manifested  in  particular  teeth  ; 
thus,  I  knew  a  gentleman  in  whom  one  of  the  permanent  incisors  of 
the  upper  jaw  did  not  come  down  before  the  fourteenth  year.  Borelli 
reports  a  woman  in  her  sixtieth  year  who  never  had  teeth ;  a  magis- 
trate of  Frederickstadt  lived  to  an  advanced  age,  and  never  had  either 
canine  or  incisor  teeth;  he  was,  however,  furnished  with  molares. 

The  teeth  are  sometimes  supernumerary  ;  it  is  not  very  uncommon 
to  see  this  manifested  by  a  single  canine  or  incisor,  and  more  frequent- 
ly in  the  upper  jaw  than  in  the  lower.  Occasionally,  there  are  several 
supernumerary  teeth. 

Cases  are  recorded  in  which  several  teeth  have  been  fused  or  joined 
together.  Bernard  Gengha  reports,  that  in  a  pile  of  bones  belonging 
to  the  Hospital  S.  Esprit,  at  Rome,  he  found  a  cranium  in  which  there 
were  only  three  teeth,  in  the  two  upper  maxillae ;  one  occupied  the 
space  of  all  the  incisors  and  the  two  cuspidati ;  and  each  of  the  others 
the  space  of  all  the  molares  of  its  respective  side.1  According  to  the 
historians  Plutarch  and  Valerius  Maximus,  Pyrrhus,  king  of  Epirus, 
and  Prusias,  king  of  Bithynia,  had  a  single  dental  piece  in  each  jaw, 
which  stood  in  the  place  of  the  usual  allowance  of  sixteen  teeth. 
These  two  cases  are  scarcely  credible,  for  the  reason,  that  for  them  to 
have  occurred,  the  middle  palate  suture,  which  is  slow  in  forming,  and 
divides  the  germs  of  the  two  sides  from  each  other,  could  not  have 
existed  during  the  foetal  state,  at  any  time  subsequent  to  the  third 
month  ;  or  what  is  more  compatible  with  this  account,  at  no  time 
whatever,  from  the  two  bones  being  consolidated,  synostosed  from  the 
beginning.  It  is  more  probable,  therefore,  that  notwithstanding  the 
royal  opportunities  of  cleanliness  possessed  by  these  distinguished 
persons,  their  teeth  were  neglected  and  permitted  to  encrust  them- 
selves with  a  dense,  thick  coat  of  tartar,  which  gave  them  the  appear- 
ance of  a  single  piece :  a  circumstance  which  occurred  to  Sabatier,  in 
a  girl  of  fifteen  or  sixteen,  and  to  Fournier  in  an  individual  of  the  same 
age  and  sex.2  Another  objection  is,  that  as  the  common  law  of  the 
germs  is  to  develop  themselves,  and  to  ossify  at  different  epochs,  in 
these  two  cases  they  were  all  not  only  proceeding  at  the  same  rate,  but 
also  joining  one  another  so  as  to  form  but  a  common  sac,  confounding, 
thereby,  all  the  known  phenomena  of  dentition. 

In  most  persons  there  are  but  two  sets  of  teeth ;  it  has  happened, 
however,  in  several  instances,  for  individuals  about  the  age  of  seventy  to 
have  one  or  more  new  teeth  belonging  to  a  third  set :  they  were  com- 

1  Sabatier,  Anat.  tome  i,  p.  78.  2  Diet,  des  Sc.  Med. 

VOL.  I. — 31 


482  ORGANS   OF  DIGESTION. 

rnonly  incisors.  J.  Hunter  saw  an  example  of  the  kind.1  The  Count- 
ess of  Desmond,  who  lived  to  her  hundred  and  fortieth  year,  had  at 
this  period,  according  to  Bacon,  a  third  set  of  teeth.3  Mentzelius 
narrates  a  similar  case3  in  the  following  words :  "  Having  accompanied 
the  Elector  of  Brandenburg  on  a  visit  to  Cleves,  in  1666,  there  arrived, 
at  the  same  time,  a  man  aged  one  hundred  and  twenty,  who  exhibited 
himself  for  money,  and  whom  I  saw  at  the  court  of  the  Elector.  His 
strength  of  voice  manifested  that  of  his  breast,  and  he  having  run 
over  the  gamut,  was  heard  at  more  than  a  hundred  paces  off.  Having 
then  opened  his  mouth,  he  showed  us  two  rows  of  pearly  teeth,  and  on 
the  subject  of  their  beauty  related  '  that  being  at  the  Hague  two  years 
before,  on  the  same  errand  which  brought  him  to  Cleves,  there  arrived 
an  Englishman  aged  one  hundred  and  twenty ;'  that  he  visited  the 
latter  and  addressed  him  in  the  following  terms :  'We  are  nearly  of 
the  same  age,  for  I  am  only  two  years  younger  than  you,  and  I  have 
had  the  greatest  desire  to  see  one  older  than  myself,  for  I  have  felt  no 
inconvenience  till  lately ;  but  during  the  three  days  that  I  have 
been  here,  I  have  had  severe  headache  and  dreadful  pains  in  the  jaws, 
which  convince  me  that  I  am  about  to  die.'  i  You  are  mistaken,  my 
dear  friend,'  said  he  to  me;  '  on  the  contrary  you  are  becoming 
younger,  for  you  are  about  to  teeth  again  like  an  infant/  'Oh  !'  an- 
swered I,  '  I  pray  to  God  not  to  punish  me  by  prolonging  my  days.' 
4 1  left  him  then  and  went  to  bed,  and  immediately  after  felt  the  most 
excruciating  pains  in  the  jaws,  which  were  followed  by  the  protrusion 
of  the  teeth  that  you  now  see.' ' 

The  circumstance  of  a  third  dentition  has  given  rise  to  a  question 
among  physiologists,  whether  the  germs  are  primarily  supernumerary  ? 
or  whether  the  gums  have  within  themselves  organs  capable  of  form- 
ing and  of  producing  new  teeth  ? 

When  such  teeth  come  out  in  a  straggling  manner,  they  hurt  the 
opposite  jaw,  and  require  to  be  extracted. 

In  old  persons  who  have  lost  all  their  teeth,  there  is  a  cartilaginous 
hardening  of  the  gum,  as  in  infancy,  whereby  they  still  retain  some 
power  of  mastication. 

When  the  body  of  the  tooth  has  been  worn  away,  nature  prevents 
the  exposure  of  its  cavity,  as  mentioned  before,  by  the  deposit  of  new 
matter  from  the  pulp  in  the  interior,  a  Crusta  Petrosa  or  Cement  (osteo- 
dentine),  which  may  be  known  by  its  darker  color,  and  by  its  trans- 
parency. 

The  muscles  of  mastication  being,  the  Temporalis,  the  Masseter,  the 
Pterygoideus  Internus,  and  the  Pterygoideus  Externus,  their  descrip- 
tion may  be  seen  elsewhere. 

1  Lor.  cit.  p.  85.  2  Hist.  vit.  et  mort.  Col.  536. 

8  Serres,  loc.  cit.  p.  40. 


THE  TONGUE. 


483 


CHAPTER  III. 
OF  THE  TONGUE. 

THE  Tongue  (lingua)  is  the  principal  organ  of  taste,  and  is  also  con- 
cerned in  mastication  and  in  speech.  It  is  an  oblong,  flattened,  sym- 
metrical, muscular  body,  which  extends  from  the  os  hyoides  posteriorly 
to  the  incisor  teeth  anteriorly,  and,  being  placed  at  the  bottom  of  the 
mouth,  fills  up  the  space  within  the  two  sides  of  the  body  of  the  lower 
jaw.  The  exact  extent  of  room  which  it  occupies  varies  according  to 
its  being  in  a  state  of  repose  or  of  activity. 

The  posterior  extremity  of  the  tongue  is  called  its  base  or  root,  and 
arises  muscular  from  the  body  and  the  cornua  of  the  os  hyoides ;  it  is 
there  considerably  thinner  than  elsewhere,  it  also  has  a  fibro-muscular 
origin  from  the  centre  of  the  epiglottis  cartilage;  sometimes  a  cartilage 
is  found  in  the  middle  of  the  base,  and  which  forms  a  sort  of  ball  and 
socket  joint  with  the  os  hyoides.  Its  anterior  extremity  is  called  the 
tip  or  point,  is  loose,  and  has  a  rounded  thin  termination.  Between 
the  point  and  the  base  is  the  body.  The  superior  surface  of  the  tongue 

Fig.  149. 


The  Tongue  with  its  papillse.— 1.  The  raphe,  which  in  some  tongues  bifurcates  on  the  dorsum  of  the 
organ,  as  in  the  figure.  2,2.  The  halves  of  the  tongue.  The  rounded  eminences  on  this  part  of  the 
organ,  and  near  its  tip  are  the  papilla?  fungiformes.  The  smaller  papillae,  among  which  the  former  are 
'ispersed,  are  the  papillae  villosae  and  filiformes.  3..  The  tip  of  the  tongue.  4.  4.  Its  sides,  on  which 
are  seen  the  lamellated  and  fringed  papillae.  5,5.  The  V-shaped  row  of  papillae  circumvallatae.  6. 
The  foramen  caecum.  7.  The  mucous  glands  of  the  roots  of  the  tongue.  8.  The  epiglottis.  9,9.  The 
fraena  epiglottidis.  10,  10.  The  greater  cornua  of  the  os  hyoides. 

(dorsum)  is  flat,  is  divided  by  a  middle  longitudinal  fissure  of  incon:i- 
derable  depth  into  two  equal  parts,  and  is  covered  by  the  lining  mem- 


484  ORGANS   OF  DIGESTION. 

brane  of  the  mouth,  under  a  particular  modification  of  structure.  The 
inferior  surface  of  the  tongue,  with  the  exception  of  its  middle  part,  is 
also  free,  and  covered  by  the  common  mucous  membrane  of  the  mouth; 
but  the  latter  is  there  very  thin,  and  the  veins  may  be  readily  seen 
shining  through  it. 

The  central  plane  of  the  tongue  has  a  very  thin  vertical  plane  of  yel- 
low elastic  ligamentous  matter  (septum  linguse],  marking  its  two  halves 
from  each  other,  and  affording  a  surface  for  the  insertion  of  muscular 
fibres.  It  is  an  extension  of  the  fibrous  matter  attaching  the  base  of 
the  tongue  to  the  os  hyoides,  but  is  more  dense  in  its  structure.1 


SECT.  I. — MUSCLES   OF   THE   TONGUE. 

The  muscles  which  compose  the  principal  part  of  the  bulk  of  the 
tongue,  are,  the  Stylo-glossus,  the  Hyoglossus,  the  Genio-hyoglossus, 
and  the  Lingualis.  As  these,  besides  belonging  to  the  general  muscu- 
lar system,  also  form  so  important  a  part  of  this  organ,  with  a  view  of 
collecting  the  account  of  its  structure,  their  description  will  be  repeated. 

1.  The  Stylo-glossus  arises  from  the  styloid  process  of  the  temporal 
bone,  and  soon  reaches  the  side  of  the  base  of  the  tongue.     Some  of  its 
fibres  extend  to  the  tip  and  confound  themselves  with  those  of  the  super- 
ficial lingual  muscle,  above  and  below  the  lateral  margin  of  the  tongue: 
while  others  form  a  broad  transverse  fasciculus,  which  is  united  to  the 
corresponding  portion  of  the  other  side  in  the  region  of  the  greater 
papillae.2 

2.  The  Hyoglossus  arises  from  the  side  of  the  base  of  the  os  hyoides, 
from  its  cornu  ;  and  from  its  appendix,  in  a  slight  degtee.     It  is  placed 
within  the  stylo-glossus,  and  extends  forwards  to  the  tip  of  the  tongue. 
Some  of  its  fibres  go  as  far  as  the  middle  line  of  the  tongue ;  others  rise 
almost  perpendicularly  upwards  at  its  base ;  while  the  remainder  are 
confounded,  along  the  margin  of  the  tongue,  with  the  superficial  lingual 
muscle. 

3.  The  Genio-hyoglossus  arises  from  the  tubercle  on  the  posterior 
face  of  the  symphysis  of  the  lower  jaw,  and  immediately  after  its  origin 
spreads  itself  after  the  manner  of  a  fan.     Its  inferior  fibres  are  inserted 
into  the  base  of  the  os  hyoides,  while  the  remainder,  by  their  diverging, 
are  inserted  into  the  whole  length  of  the  tongue  from  its  base  to  its 
point.     This  muscle  is  in  contact,  side  by  side,  with  its  fellow,  and  there 
is  a  sort  of  fissure  with  a  small  quantity  of  adipose  matter  between 
them. 

As  the  fibres  of  this  muscle  go  from  below  upwards,  they  penetrate 

1  Mr.  Baur  has  described  a  cartilaginous  lamina  beginning  at  the  point  of  the  tongue  and 
going  back  to  its  base;   it  is  said  to  be  found  along  the  inferior  surface  of  the  organ. — Cruveil- 
hier,  Anat.^  vol.  ii.    I  have  not  met  with  it.    Krause  has  also  described  something  of  the  same 
kind. 

2  See  Cloquet's  Anat.  pi.  cxx. 


MUSCLES  OF  THE  TONGUE. 


485 


to  the  upper  surface  of  the  tongue ;  and,  consequently,  traverse  the 
transverse  lingual  muscles  and  the  superficial  lingual. 

4.  The  Lingualis  is  a  small  narrow  fasciculus  of  fibres,  which  arises 
indistinctly  about  the  root  of  the  tongue,  in  the  yellow  elastic  tissue 
there,  and  advances  to  the  tip  between  the  hyoglossus  and  the  genio- 
hyoglossus. 

5.  The  Superficial  Lingual  Muscle  (superficialis  linguse)  is  a  broad, 
thin  layer,  covering  the  upper  surf-ice  of  the  tongue,  below  the  mucous 
membrane;  it  begins  behind,  on  a  line  with  the  greater  papillae,  and 
advances  forwards  to  the  tip.     Its  more  internal  fibres  converge  and 
end  at  the  middle  line,  but  the  external  ones  terminate  above  and  below 
near  the  margin  of  the  tongue.     It  is  rather  equivocally  seen  in  the 
human  subject;  in  the  calf  it  is  very  distinct. 

Immediately  under  the  superficial  lingual  muscle  there  is  formed  occa- 
sionally, according  to  my  personal  observations,  an  elliptical  plane  of 
muscle  about  two  inches  long  and  six  or  eight  lines  wide;  the  ends  of 
its  fibres  begin  and  terminate  in  the  middle  septum  of  the  tongue.  It 

Fig.  1 50. 


Horizontal  Section  of  Tongue  about  two  lines  below  its  Dorsura. — 1,  1.  Musculus  ovalis  linguce.  2, 
2.  Root  of  tongue.    3,  3.  Transverse  lingual  muscles. 

may  be  called  the  Ovalis  Linguse,  and  can  be  readily  found  by  hard- 
ening the  tongue  and  then  slicing  it  horizontally  with  a  thin  broad  knife. 
Its  fasciculi  are  parted  by  the  ascending  fibres  of  the  genio-hyoglossi. 

6.  The  Transverse  Lingual  Muscles  (transversales  linguse)  consist 
in  small  scattered  fasciculi,  which  are  placed  below  the  last,  and  in  the 
thickness  of  the  tongue,  which  they  traverse  at  right  angles.  One  end 
of  them,  on  each  side,  ceases  at  the  middle  line  of  the  tongue,  where 
there  is  the  small  seam  or  thin  septum  of  fibrous  matter  as  stated,  and 
the  other  end  terminates  in  the  covering  membrane  of  the  tongue,  at 


486  ORGANS  OP  DIGESTION. 

the  lateral  margin  of  this  organ.  These  fibres  are  to  be  found  in  the 
whole  length  of  the  tongue,  and  gradually  become  more  curved  at  its 
base. 

7.  The  Vertical  A  Lingual  Muscles  (vertieales  linguse)  extend  from 
the  upper  to  the  under  investing  membrane  of  the  tongue.  They  con- 
sist in  small  scattered  fasciculi,  like  the  preceding,  and  cross  them  at 
right  angles  in  traversing  the  thickness  of  the  tongue.1  Many  of  these 
fibres  appear  to  me  to  proceed  from  the  genio-hyoglossus. 


SECT.  II. — MUCOUS  COVERING  OF  THE  TONGUE. 

The  mucous  membrane  of  the  mouth,  where  it  forms  the  fraenum  lin- 
guse, is  over  the  anterior  margin  of  genio-hyoglossi  muscles,  and  forms 
according  to  Fleischman2  a  pouch  on  each  side  of  the  fraenum  linguae. 
The  same  membrane,  in  going  from  the  base  of  the  tongue  to  the  epi- 
glottis, and  forming  another  fraenum,  has,  on  each  side  of  it,  a  depres- 
sion or  pouch  in  which  articles  of  food  sometimes  lodge.  Beneath  the 
last  fraenum  is  a  ligamentous  tissue  (ligament,  glosso-epiglot.  med.\ 
which  runs  to  the  base  of  the  tongue  from  the  front  of  the  epiglottis, 
and  serves  to  keep  the  latter  erect:  some  muscular  fibres  are  occasion- 
ally seen  in  this  tissue  in  the  human  subject ;  in  the  black  bear  of  North 
America,  and  in  some  other  animals,  it  consists  in  a  pair  of  strong  mus- 
cles. The  pouch,  on  each  side,  is  bordered,  externally,  by  a  more  super- 
ficial doubling  of  the  mucous  membrane  (ligament,  glosso-epiglot.  later. 
or  Jiyo-epiglot.)^  which  passes,  from  the  base  of  the  tongue  to  the  side 
of  the  epiglottis.3 

The  mucous  membrane  of  the  mouth,  as  it  is  reflected  over  the  tongue 
so  as  to  make  an  investment  (involucrum  linguse)  for  it,  presents  some 
striking  varieties :  on  the  under  surface  it  is  thin  and  delicate,  but  on 
the  upper  surface  it  has  the  papillary  structure  well  developed  on  the 
body  and  tip.  At  the  base,  the  strength  of  the  involucrum  is  consider- 
able, owing  to  the  abundance  of  the  yellow  fibrous  or  elastic  tissue  there, 
which  makes  a  complete  corium  adhering  to  the  os  hyoides,  the  epi- 
glottis, to  the  muscular  fibres  below,  and  having  many  mucous  follicles 
and  glands  set  into  it.  This  tissue  is  continued  forward  over  the  dorsum 
of  the  tongue,  not  so  thick  as  behind,  but  more  condensed  in  its  struc- 
ture, so  as  to  have  a  firm  fibrous  feel :  its  upper  surface  is  studded  with 
the  papillary  structure,  and  its  lower  surface  receives  the  insertion  of 
muscular  fibres  everywhere  with  the  utmost  closeness  like  a  bone,  so 
that  there  is  no  sliding  in  it.  This  upper  portion  of  the  involucrum 
may  be  considered  as  inflected  downwards  in  the  middle  of  the  tongue 
so  as  to  make  the  septum  linguae.  The  dorsal  involucrum  is  in  some 
cases  of  dyspepsia  liable  to  lose  its  elasticity  in  lines,  traversing  it  in 

1  The  preceding  views  of  the  Superficial,  Transverse  and  Vertical  lingual  muscles  have 
bean  introduced  by  M.  Gerdy  of  Paris.      See  J.  Cloquet,  Anat.  de  L'Homme,  pi.  cxix. 
cxx. — J.  F.  Meckel,  loc.  cit.     Note  des  Traducteurs,  vol.  iii.  p.  313. 

2  Huschke,  Trait6  de  Splanch.  p.  540. 

8  This  doubling  also  exhibits,  occasionally,  a  small  muscle  inserted  into  its  base,  and  aris- 
ing from  the  upper  constrictor  of  the  pharynx,  and  which  has  the  effect  of  widening  the 
pouch. 


MUCOUS  COVERING  OP  THJi  TONGUE.  487 

different  directions  and  extending  to  the  base  of  the  papillae.  This  con- 
stitutes what  is  called  the  chapped  tongue,  difficult  to  cure,  but  improv- 
able by  lunar  caustic  applied  along  the  lines. 

The  mucous  membrane,  on  the  dorsum  of  the  tongue,  is  remarkable 
for  the  size  and  development  of  its  papillae,  and  for  having  its  epidermis 
(jperiglottis]  easily  detached. 

The  anterior  two-thirds  of  the  upper  surface  of  the  tongue  are 
entirely  covered  by  these  papillae.  They  are  so  thickly  set  as  to  touch 
one  another :  and,  as  they  present  some  peculiarities  of  form,  they  are 
divided  into  Papillae  Maximse  or  Capitata3,  Mediae,  Villosae,  and  Fili- 
formes. 

The  Papillae  Maximse  constitute  the  posterior  border  of  the  papil- 
lary surface  of  the  tongue,  and  are  about  nine  in  number,  though  they 
are  frequently  fewer,  and  sometimes  more.  They  are  much  larger  than 
the  others,  measuring  a  line  or  more  at  their  base,  are  disposed  in  two 
oblique  rows,  which,  by  converging  backwards,  meet  and  generally  form 
something  like  the  letter  V ;  the  fifth  papilla  being  the  angle  of  the 
figure.  Each  of  these  bodies  resembles  a  cone  standing  upon  its  sum- 
mit, and  is  surrounded  by  a  circular  fossa  which  permits  it  to  project 
but  inconsiderably  above  the  general  level  of  the  tongue.  Sometimes 
two  or  more  are  in  the  same  fossa. 

Most  commonly  the  central  papilla  maxima  has  the  largest  fossa  of 
any  of  that  class,  and  which  is  frequently  designated  by  the  term 
foramen  caecum.  But  the  regular  Foramen  Caecum,  frequently  defi- 
cient, is  a  little  behind  this  foramen,  and  is  not  furnished  with  a  papilla; 
into  it  some  mucous  follicles  discharge  their  contents.  From  time  to 
time  it  has  been  fallaciously  considered  as  receiving  the  excretory  duct 
of  the  thyroid,  or  of  some  of  the  salivary  glands. 

The  Papillae  Mediae,  or  Fungiformes,  are  more  numerous  than  the 
last,  and  next  to  them  in  size ;  they  are  enlarged  at  their  loose  end 
into  a  sort  of  rounded  head  like  a  mushroom,  whence  their  name  ; 
they  are  irregularly  scattered  over  the  tongue.  Those  which  are  next 
in  size  and  still  more  abundant  are  the  Papillse  Villosae,  and  are  of  a 
more  cylindrical  shape.  The  Papillae  Filiformes  being  of  a  thread- 
like shape,  fill  up  the  intervals  of  .the  others;  are  the  smallest,  and 
are  found  principally  near  the  middle  of  the  tongue  and  at  its  front 
extremity. 

The  papillae  of  the  tongue,  though  they  vary  in  their  shape  and  size, 
have  very  much  the  same  structure  in  regard  to  the  abundance  of  blood- 
vessels and  nerves  which  enter  into  their  composition.  When  uninject- 
ed  and  viewed  with  the  naked  eye,  their  surface  appears  smooth,  but 
when  made  turgid  by  injection,  they  are  covered  with  little  asperities  or 
filaments,  which  seem  to  be  formed  principally  of  blood-vessels,  having 
a  very  tortuous  and  superficial  course;  forming  loops  or  doublings,  in 
projecting  on  the  surface  of  the  papilla,  and  anastomosing  freely  with 
each  other.1  Besides  vessels,  there  is  a  soft  whitish  substance,  sup- 
posed to  be  nervous,  entering  into  the  composition  of  each  filament. 
The  larger  papillae  on  the  back  part  of  the  tongue  are  supplied  by  the 
glosso-pharyngeal  nerve,  and  the  papillae  on  its  front  part  by  the  trige- 
minus  or  fifth  pair. 

1  Scemmering,  Anat.     J.  Cloquet,  pi.  cxix. 


488  ORGANS  OF  DIGESTION. 

Messrs.  Todd  and  Bowman1  have  presented  some  good  additional 
observations  on  the  structure  of  the  papillae  linguales.  They  have 
remarked  fine  hairs  growing  from  some  of  them  ;  owing  to  their  epithe- 
lial structure  or  covering,  becoming  extremely  dense.  They  have  also, 
with  Huschke,  pointed  out  the  existence  of  secondary  papillae  exceed- 
ingly fine,  upon  the  periphery  of  the  others.  We  may  remark  that  in 
this  respect,  there  is  a  strong  resemblance  with  the  villi  of  the  intes- 
tines of  the  Rhinoceros,  which  are  very  large  and  beset  in  the  same 
way,  with  fine  filaments  projecting  from  them ;  and  also  with  the  pa- 
pillae tactus  of  the  human  skin,  which  from  that  cause  have  a  tufted 
appearance  under  the  microscope. 

The  surface  of  the  tongue  between  the  papillae  maximae  and  the  os 
hyoides  is  destitute  of  such  papillae,  and  is  covered  only  by  the  common 
mucous  membrane  of  the  mouth,  which  is  very  thin  there,  compared 
to  that  in  advance  of  the  papillae  maximae ;  and  has  beneath  it  many  mu- 
ciparous  glands,  which  in  different  individuals  produce  prominences  more 
or  less  elevated,  and  are  of  a  lenticular  shape  with  a  diameter  of  a 
line  or  two.  Their  orifices  are  very  visible,  and  easily  receive  a  large 
bristle,  or  a  probe  of  common  size.  Follicles  of  a  small  size,  and 
comparable  to  those  of  the  intestines,  exist  also  over  the  whole  surface 
of  the  tongue ;  it  would  seem,  however,  an  essential  mistake,  to  consi- 
der the  papillae  maximae  as  composed  of  them,  as  asserted  by  some. 

The  intervals  of  these  gustatory  papillae,  and  the  back  of  the  tongue, 
like  other  parts  of  the  lining  membrane  of  the  mouth,  exhibit  the  ordi- 
nary papillae  tactus. 

Fig.  151. 


fit 


Capillary  Net- work  of  a  fungiform  papilla  of  the  tongue,  injected  minutely. 

The  Epidermis,  which  is  found  upon  all  other  parts  of  the  lining 
membrane  of  the  mouth,  is  also  continued  over  the  whole  upper  surface 
of  the  tongue,  and  consequently  invests  each  papilla  ;  it  is  called 
there  Peri-glottis.  It  is  soft  and  humid,  may  be  detached  by  macera- 
tion, and  is  frequently  detached  in  fevers.  On  its  upper  surface,  it, 
when  detached,  will  have  many  elevations  ;  while  on  the  lower  there 
will  be  corresponding  excavations,  which  to  superficial  observation  with 
transmitted  light  give  it  the  appearance  of  being  cribriform. 

The  tongue  is  supplied  with  arteries,  principally  from  the  lingual 
branch  of  the  carotid  :  and  with  nerves  from  the  hypoglossal,  the  fifth 

1  Physiol.  Anat.  pt.  ii.  p.  435. 
• .  i 


MUSCLES  OP  THE  PALATE.  489 

pair,  and  the  glosso-pharyngeal.  The  former  nerve  is  considered  to  be 
exclusively  appropriated  to  its  muscular  movements,  and  the  two  latter 
to  its  sensations.  Its  faculty  of  taste  seems  to  be  most  active  at  the 
tip  ;  on  the  sides,  and  near  the  middle  behind,  it  is  inconsiderable. 
The  soft  palate  seems  also  to  participate  in  the  function  of  taste. 

Fig.  152. 


Comparative  view  of  the  Scales  of  the  Epithelium.  A.  Section  of  the  epithelium  of  the  conjunctiva, 
some  scales  loosened  : — B.  Scales  taken  from  the  inner  surface  of  the  cheek  ;  the  margin  of  one  is  fold- 
ed, a  frequent  appearance  of  these  scales,  showing  their  thinness  and  flexibility,  c.  The  more  deeply- 
seated  or  recently  formed  scales  or  cellules  from  the  human  conjunctiva.1 


CHAPTER  IV. 
OF  THE  PALATE. 

THE  Palate  (palatum)  is  composed  at  its  anterior  part  of  the  pala- 
tine processes  of  the  superior  maxillary  and  palate  bones,  covered 
above  by  the  pituitary  membrane,  and  below  by  the  lining  membrane 
of  the  mouth.  This  portion  of  it  is  the  hard  palate,  and  separates  the 
mouth  from  the  nose.  Behind  it  is  a  portion  exclusively  membranous, 
and  called  the  soft  palate,  which  separates  partially  the  mouth  from 
the  upper  part  of  the  pharynx. 

That  part  of  the  lining  membrane  of  the  mouth  which  covers  the 
hard  palate  (membrana  palatina)  has  a  firm,  fibrous  feel,  is  not  so 
vascular  or  sensible  as  other  parts,  and  is  made  of  a  mixture  of  white 
and  yellow  fibrous  tissue,  which  is  strongly  fastened  to  the  bone.  It 
has  a  ridge  in  its  centre  just  beneath  the  middle  palate  suture,  and 
from  each  side  of  it  there  are  transverse  ridges  extending  to  the  alve- 
olar processes.  This  arrangement  is  more  evident  at  its  anterior  part, 
and  in  middle-aged  persons  ;  in  the  old  it  is  faint,  and  frequently  does 
not  exist  when  the  alveoli  are  gone.  Beneath  this  membrane,  particu- 
larly at  its  posterior  part,  the  muciparous  glands  are  very  abundant 
and  closely  set  against  each  other,  so  as  to  form  a  perfect  layer,  ex- 
tending itself  upon  the  front  of  the  soft  palate,  and  making  one-half 
of  its  thickness. 

The  Soft  Palate  (velum  pendulum  palati)  has  an  oblong  shape, 
and  being  continued  from  the  posterior  margin  of  the  hard  palate,  it 
is  stretched  across  the  back  of  the  mouth  from  one  side  to  the  other, 
and  lies  obliquely  downwards  and  backwards.  Its  inferior  margin, 

1  The  last  two  figures  are  copied  from  Dr.  Henle's  paper,  Symbols  ad  Anat.  villor.  in- 
testin.,  imprimis  eorum  epithelii  et  vasorum  lacteorurn. 


490  ORGANS  OF  DIGESTION. 

which  is  free,  offers  in  its  centre  a  projection  of  half  an  inch  or  three- 
quarters  in  length,  which  is  the  Uvula.  From  each  side  of  the  latter 
there  proceed  two  crescentic  doublings  of  the  lining  membrane  of  the 
mouth,  called  the  lateral  half  arches  of  the  palate. 

The  Anterior  Half  Arch  is  more  distinct  than  the  other,  and 
arising  at  the  side  of  the  uvula  by  one  end,  terminates  by  the  other 
in  the  side  of  the  base  of  the  tongue,  on  a  line  with  the  papillae 
maximse. 

The  Posterior  Half  Arch  arises  from  the  side  of  the  uvula  near  the 
last,  and  diverging  from  it  backwards  and  outwards,  has  the  other  end 
lost  gradually  in  the  lining  membrane  of  the  pharynx  near  its  middle. 

In  the  depression  between  these  duplications,  on  either  side,  is  the 
Tonsil  Gland.  The  space  bounded  in  front  and  behind  by  these  lateral 
half  arches  is  the  Fauces,  and  the  anterior  opening  into  it  is  the 
Isthmus  of  the  Fauces. 

When  the  mucous  membrane  of  the  soft  palate  is  removed,  its  mus- 
cles are  exposed,  and  are  as  follows: — 

1.  The  Constrictor  Isthmi  Faucium  is  a  small  fasciculus  of  fibres, 
on  each  side,  within  the  duplicature  of  the  anterior  lateral  half  arch. 
It  arises  from  the  middle  of  the  soft  palate  near  the  base  of  the  uvula, 
and  is  inserted  into  the  side  of  the  tongue  near  its  root  in  a  line  with 
the  papillae  maximae. 

It  tends  to  close  the  opening  between  the  mouth  and  the  pharynx. 

2.  The  Palato-Pharyngeus  is  also   a   small  fasciculus,  within   the 
duplicature  forming  the  posterior  lateral  half  arch.     It  arises  from 
the  middle  of  the  soft  palate  near  the  base  of  the  uvula,  and  is  in- 
serted into  the  pharynx  at  the  space  between  the  middle  and  the  lower 
constrictors  behind  the  stylo-pharyngeus,  and  into  the  posterior  margin 
of  the  thyroid  cartilage.     It  spreads  itself  out  considerably,  so  as  to 
cover,  along  with  the  stylo-pharyngeus,  almost  the  whole  posterior 
lateral  portion  of  the  pharynx  at  its  lower  part. 

It  draws  the  soft  palate  downwards,  or  will  draw  the  pharynx  up- 
wards and  shorten  it,  and  it  will  dilate  somewhat  the  orifice  of  the 
Eustachian  tube,  by  means  of  a  connection  which  it  forms  by  the  small 
fasciculus  of  muscular  matter,  called  the  Levator  Pharyngis  internes 
of  Eustachius.1 

3.  The  Circumflexus,  or  Tensor  Palati,  is  behind  the  pterygoid  pro- 
cess of  the  sphenoid  bone.     It  arises  from  the  spinous  process  of  the 
latter  along  the  foramen  ovale,  and  from  the  contiguous  part  of  the 
Eustachian  tube ;  it  then  passes  downwards  in  contact  with  the  ptery- 

1  Custom  has  sanctioned  the  above  mode  of  description,  but  the  latter  does  not  express 
fully  the  condition  of  this  muscle,  for  it  is  a  well-marked  broad  fasciculus  below.  It  would 
be  more  conformable  to  nature  to  say,  that  it  arises  from  almost  the  whole  posterior  margin 
of  the  thyroid  cartilage,  being  there  much  spread  out;  that  it  ascends  within  the  constrictors 
of  the  pharynx  by  collecting  its  fasciculi  and  having  their  number  reduced ;  that  it  is  inserted 
into  the  side  of  the  soft  palate;  and  that  a  point  of  it  may  be  traced  within  the  Levator 
Palati  to  the  inferior  corner  of  the  cartilage  of  the  Eustachian  tube,  into  which  it  is  inserted. 
This  slip  being  the  Levator  Pharyngis  internus  of  Eusiachius.  This  muscle  will  be  better 
understood  with  the  description  of  the  pharynx. 


MUSCLES  OP  THE  PALATE.  491 

goideus  interims  muscle,  and  terminates  in  a  broad  tendon  below,  which 
winds  around  the  hook  of  the  internal  pterygoid  process,  and  is  inserted 
into  the  soft  palate  near  its  middle,  and  into  the  posterior  lunated 
edge  of  the  palate  bone. 

It  spreads  out  or  extends  the  palate. 

4.  The  Levator  Palati  is  on  the  inner  side  of  the  last.     It  arises 
from  the  point  of  the  petrous  bone,  and  from  the  contiguous  part  of 
the  Eustachian  tube,  and  passes  downwards  to  be  inserted  into  the  side 
of  the  soft  palate,  not  far  from  its  middle.     This  muscle,  in  the  ex- 
ternal dissection  of  the  pharynx,  may  be  seen  between  its  external 
edge  and  the  pterygoideus  internus  muscle. 

It  draws  the  soft  palate  upwards. 

5.  The  Azygos  Uvulae  is  in  the  centre  of  the  soft  palate  and  of  the 
uvula.     It  arises  from  the  posterior  pointed  termination  (spina  nasalis 
posterior),  of  the  middle  palate  suture,  and  goes  down  into  the  uvula. 
The  origin  of  this  muscle  adheres  also  to  the  posterior  margin  of  the 
septum  narium,  and  its  point  below  stops  half  an  inch  short  of  the  in- 
ferior end  of  the  uvula.     When  the  mucous  membrane  at  the  tip  of  the 
latter  is  laid  open,  it  will  be  found  that  the  tip  is  formed  of  a  loose 
areolar  substance,  with  some  small  salivary  or  muciparous  glands  scat- 
tered through  it.     The  morbid  elongation  of  the  uvula  is  confined  to 
the  tip,  and  seldom  extends  to  the  muscle,  hence  the  excision  of  the 
tip  answers  every  purpose  when  such  an  operation  is  demanded. 

The  Azygos  Uvulae  is  just  under  the  posterior  mucous  membrane  of 
the  soft  palate. 

It  draws  the  uvula  upwards,  and  diminishes  the  vertical  breadth  of 
the  soft  palate.  The  precise  use  of  the  uvula  is  undetermined ;  it  is 
supposed  to  regulate  the  pronunciation  of  certain  letters,  especially  R. 
It  appears  to  me  to  be  chiefly  employed  in  making  the  inferior  margin 
of  the  soft  palate  fit  well  against  the  back  and  upper  half  of  the  pha- 
rynx, in  vomiting  and  other  motions,  and  thereby  occluding  the  nose 
for  the  time. 

The  symmetrical  division  of  it  is  sometimes  very  strongly  marked 
by  a  seam,  hence  the  muscle  looks  like  two,  closely  adherent,  and  is  by 
some  called  the  Levatores  Uvulae. 

Dr.  Tourtual  has  detected  a  small  muscle  connected  with  the  orifice 
of  the  Eustachian  tube,  and  the  line  below  of  the  posterior  bony  naris, 
and  descending  thence  to  be  lost  in  the  lateral  and  anterior  part  of  the 
soft  palate  near  the  circumflexus  palati. 

When  the  mucous  membrane  is  removed,  the  upper  constrictor  of  the 
pharynx  appears  between  the  anterior  and  the  posterior  half  arch. 

The  white  median  line  of  the  soft  palate,  running  to  the  incisive 
teeth,  is  considered  by  Dr.  Pappenheim  to  be  formed  of  longitudinal 
elastic  fibres ;  which  on  the  velum  palati  send  filaments  transversely 
towards  the  tonsils. 


492  ORGANS  OF  DIGESTION. 


CHAPTER  V. 
OF  THE  GLANDS  OF  THE  MOUTH. 

THESE  glands  consist  in  such  as  are  muciparous,  and  in  such  as  are 
salivary. 

SECT.  I. — MUCIPAROUS  GLANDS. 

These  glands  (glandulse  muciparse)  are  whitish,  somewhat  oval  and 
flattened,  and  are  from  the  fraction  of  a  line  to  two  lines  in  diameter : 
they  are  found  in  great  abundance  beneath  the  lining  membrane  of  the 
mouth  at  seyeral  places,  to  wit:  on  the  lips  (gland,  labiales);  on  the 
cheeks  (gland,  buccales)',  and  also,  as  mentioned,  at  the  posterior 
part  of  the  upper  surface  of  the  tongue  (gland,  mucip.  linguse). 
The  layer  of  them  (gland,  palatinae),  which  is  found  under  the  lining 
membrane  of  the  hard  palate,  is  also  continued  over  the  anterior  and  the 
posterior  surface  of  the  soft  palate,  especially  the  anterior  surface. 

A  great  many  small  pores  are  observed  on  the  internal  surface  of  the 
mouth,  which  are  the  orifices  of  the  ducts  of  these  glands. 

Notwithstanding  the  marked  difference  in  the  common  mucous  glands 
from  the  labial  and  buccal,  and  the  close  approximation  in  appearance 
of  the  latter  two  with  the  lobules  of  the  salivary  glands,  yet  the  labial 
and  buccal  have  almost  universally  been  put  into  the  category  of 
the  mucous.  More  correct  views  have,  however,  been  lately  advanced 
through  the  aid  of  the  microscope  by  Henle,  who  now  says,  definitely, 
that  the  labial  and  buccal  glands  are  of  the  same  structure  with  the 
salivary.  Their  substance  consists  of  a  mass  of  round,  or  oval,  com- 
pletely closed  cells  of  different  sizes,  some  containing  a  granular  matter 
and  others  perfectly  formed  mucous  globules.  A  number  of  these  cells 
united  by  cellular  tissue,  and,  perhaps,  also  by  a  structureless  membrane, 
form  an  acinus,  and  as  such,  are  seated  upon  a  branch  of  the  excretory 
duct.  Into  this  duct,  mucous  globules  and  other  matter  contained  in 
the  cells,  are  at  times  poured  from  the  dehiscence  of  the  membrane  of 
the  cells,  or  from  its  dissolving  at  the  place  of  junction  with  the  duct. 

According  to  Henle,  there  are  also  other  organs  in  every  mucous 
membrane  without  exception  ;  they  are  round  or  oval  closed  cells,  visi- 
ble even  to  the  unassisted  eye,  being  sometimes  quite  transparent,  but 
at  other  times  filled  with  mucous  globules.1 

The  glands  upon  the  hard  and  soft  palate,  according  to  the  above, 
may  also  be  considered  as  belonging  to  the  system  of  salivary  glands. 

The   Tonsils  (tonsillde,    amygdalae),  situated   as   observed,  one    on 

'  Mailer's  Physiol.  p.  479. 


SALIVARY  GLANDS.  493 

each  side,  between  the  half  arches  of  the  palate,  are  six  or  eight  lines 
long,  four  or  five  wide,  and  about  three  thick.  They  are  rather  a  col- 
lection of  large  mucous  follicles,  than  a  congeries  of  glandular  bodies, 
in  consequence  of  which  their  surface  is  very  much  reticulated.  Owing 
to  their  being  placed  upon  the  upper  constrictor  of  the  pharynx,  their 
mobility  is  very  striking  and  considerable. 

There  is  a  very  sensible  difference  between  the  Glandulae  Muciparae 
Linguae,  and  the  Glandulae  Labiales,  and  Buccales.  In  the  case  of  the 
two  latter  each  gland  has  a  number  of  microscopic  orifices,  perhaps  one 
for  each  granule  or  acinus  of  the  gland,  opening  in  the  interior  of  the 
mouth.  These  orifices  are  too  small  to  be  seen  with  the  naked  eye,  and 
we,  therefore,  resort  to  the  microscope.  Such  glands  are  also  gene- 
rally spheroidal.  But  in  the  case  of  the  glandulae  linguae,  they  are  of  a 
flattened  lenticular  shape,  and  each  gland  has  a  solitary  large  orifice 
proceeding  from  its  centre  to  the  surface  of  the  tongue,  and  into  which 
a  pointed  probe  may  be  easily  introduced.  The  tonsils  are,  in  fact,  a 
clustered  exhibition  of  this  arrangement,  the  orifices  of  the  glands 
crossing  each  other  so  as  to  give  a  reticulated  condition.  A  structure 
the  same  as  that  of  the  glandule  linguae  is  continued  from  them,  all 
the  way  to  the  tonsils,  over  the  lower  part  of  the  fauces. 

It  appears  then  that  the  glandulae  buccales,  labiales,  and  palatinse 
ought  to  be  viewed  as  salivary  glands;  while  the  tonsils,  the  glandulae 
muc.  linguae,  and  the  similar  continuous  range  to  the  tonsils  over  the 
bottom  of  the  fauces,  are  really  mucous  glands. 

The  preceding  points  of  structure  are  made  more  manifest  by  steep- 
ing the  parts  in  spirits  of  wine,  after  macerating  them  for  a  few  days 
in  water. 

I  have  in  some  cases  seen  the  glandulse  linguae  clustered,  and  forming 
two  broad  elevated  collections  on  each  side  of  the  tongue,  somewhat 
like  the  tonsil  gland,  instead  of  making  a  uniform  layer  as  in  common. 


SECT.  II. — SALIVARY  GLANDS. 

On  either  side  of  the  neck,  bordering  upon  the  mouth,  there  are 
three  glandular  bodies  for  the  secretion  of  saliva;  they  are  the  Parotid, 
the  Submaxillary,  and  the  Sublingual.  The  fluid  secreted  from  them 
is  of  great  service  in  digestion,  and  is  blended  with  the  food  in  mastica- 
tion, and  in  swallowing.  According  to  Berzelius,  it  has  a  considerable 
affinity  for  oxygen,  and  consists  in  a  white  mucous  substance,  holding, 
in  a  state  of  solution,  the  saline  articles  usually  found  in  the  serum  of 
the  blood. 

The  Parotid  Gland  (glandula  parotis)  is  the  largest  of  the  three, 
and,  like  the  others,  is  of  a  light  pink  color.  Owing  to  the  space  into 
which  it  is  crowded,  it  is  of  a  very  irregular  figure.  It  fills  up  the  ca- 
vity on  the  side  of  the  head  between  the  mastoid  process  and  the  ramus 
of  the  lower  jaw,  extending  beyond  the  edge  of  the  latter  so  as  to  cover 
the  posterior  margin  of  the  masseter  muscle.  It  is  somewhat  pointed 
at  its  fore  part.  Its  vertical  length  reaches  from  the  zygoma  above, 
to  the  angle  of  the  jaw  below;  sometimes,  indeed,  a  little  lower  down. 


494  ORGANS   OF  DIGESTION. 

In  thickness  it  extends  from  the  integuments  externally,  to  the  styloid 
process,  the  styloid  muscles,  and  the  tendon  of  the  digastricus,  inter- 
nally; being  there  only  separated  from  the  internal  carotid  artery  by 
these  parts.  It  is  traversed  from  behind  forwards  by  the  portio-dura 
nerve,  and  from  below  upwards  along  its  internal  margin  by  fclae  ex- 
ternal carotid  artery  and  the  temporal  vein. 

This  gland  has  no  appropriate  capsule,  but  being  covered,  on  its 
external  face,  by  the  continuation  of  the  fascia  superficialis  of  the  neck, 
prolongations  are  sent  from  the  fascia  which  penetrate  it  in  every  direc- 
tion, and  keep  its  lobules  together. 

Its  duct  (ductus  stenonianus],  formed  by  a  coalition  of  branches,  de- 
parts from  its  anterior,  edge  a  few  lines  below  the  zygoma,  and  traverses 
the  outer  face  of  the  inasseter  muscle,  in  a  line,  according  to  the  obser- 
vations of  Dr.  Physick,  drawn  from  the  lobe  of  the  ear  to  the  end  of 
the  nose.  It  is  about  the  size  of  a  crow-quill,  is  hard  and  tendinous, 
with  thick  parietes.  It  lies  close  to  the  masseter  muscle,  and  at  the 
anterior  edge  of  the  latter  penetrates  a  pad  of  fat  commonly  found 
there  on  the  side  of  the  cheek;  it  then  perforates  the  posterior  end  of 
the  buccinator,  so  as  to  have  its  oral  orifice  opposite  the  second  large 
molar  tooth  of  the  upper  jaw.  On  opening  the  mouth  wide  during  a 
state  of  fasting,  a  jet  of  saliva  will  sometimes  indicate  the  position  of 
this  orifice. 

A  small  gland  (gland,  accessoria  parotidis)  is  sometimes  found  be- 
tween this  duct  and  the  zygoma ;  it  varies  in  form  and  size,  -and  has  a 
distinct  excretory  canal  discharging  itself  into  the  parotid  duct. 

In  attendance  upon  the  parotid  duct  there  are  some  small  glands, 
called  Molar,  about  the  size  of  common  shot,  and  looking  like  lobules 
of  the  parotid ;  they  are  found  near  its  entrance  into  the  buccinator, 
being  much  concealed  between  the  buccinator  and  the  masseter.  There 
is  some  difficulty  in  tracing  their  ducts,  but  they  probably  discharge 
into  the  duct  of  the  parotid. 

The  Submaxillary  gland  (glandula  submaxillaris)  is  not  more  than 
a  third  or  so  the  size  of  the  parotid,  and  has  a  more  regular  form  in 
being  somewhat  ovoidal.  It  is  accommodated  in  the  depression  on  the 
side  of  the  neck  formed  by  the  body  of  the  lower  jaw  externally,  by 
the  mylo-hyoid  muscle  above,  and  by  the  tendon  of  the  digastric  below. 
The  platysma  myoides  intervenes  between  it  and  the  skin.  It  almost 
touches  the  parotid  gland  behind,  being  separated  from  it  only  by  the 
process  sent  in  from  the  fascia  superficialis,  and  continuous  with  the  liga- 
ment, wh'ich  goes  from  the  styloid  process  to  the  ramus  of  the  lower  jaw. 
As  it  extends  to  the  posterior  margin  of  the  mylo-hyoid  muscle,  it  there 
touches  the  sublingual  gland.  The  facial  artery  either  passes  through 
it  or  is  very  much  connected  with  it. 

Its  color  and  appearance  are  the  same  with  the  parotid ;  but  its 
lobules  are  more  easily  separated,  as  they  are  held  together  only  by 
weak  cellular  substance,  which  forms  a,  sort  of  capsule  to  them.  Its 
duct  (ductus  Whartonianus),  which  is  single,  comes  from  the  assem- 
bling and  junction  of  branches  from  the  several  lobes.  It  is  much 


SALIVARY  GLANDS.  495 

thinner,  more  extensible  and  larger  in  proportion  than  the  parotid 
duct ;  and  being  directed  backwards,  winds  over  the  posterior  edge  of 
the  mylo-hyoid  muscle  in  order  to  get  to  the  cavity  of  the  mouth.  It 
then  passes  along  the  internal  face  of  the  sublingual  gland,  below  the 
tongue,  and  terminates  by  a  small  projecting  orifice  on  the  anterior 
margin  of  the  fraenum  linguae. 

A  continuation  of  the  substance  of  this  gland  (gland.  BartJiolini- 
ana),  of  a  few  lines  in  thickness,  described  by  Bartholin,  is  found  at 
the  posterior  end  of  the  sublingual  gland,  and  has  its  excretory  duct 
sometimes  opening  into  the  side  of  the  duct  of  Wharton,  and,  on  other 
occasions,  into  one  of  the  ducts  which  issue  from  the  sublingual  gland. 
When  this  common  duct  exists,  it  is  called  the  canal  of  Bartholin 
(ductus  BarthoL),  who  first  discovered  it  in  the  lion,  in  1684. 

The  Sublingual  Gland  (glandula  sublingualis)  is  an  oblong  body 
covered  by  the  lining  membrane  of  the  mouth,  but  visible  when  the 
tongue  is  turned  up.  It  is  placed  above  the  mylo-hyoid  muscle,  along 
the  under  surface  of  the  tongue,  and  is  readily  distinguished  by  its 
ridged  unequal  surface,  projecting  into  the  mouth.  It  is  not  so  large 
as  the  submaxillary  gland. 

Its  lobules  are  smaller  than  those  of  the  preceding  gland,  and  are 
also  whiter  and  harder.  Instead  of  having  but  one  excretory  duct, 
it  has  several ;  sometimes  fifteen  or  twenty  of  them  are  discernible : 
on  other  occasions,  several  of  them  are  collected  into  one  or  two  prin- 
cipal trunks  (ductus  Riviniani),  and  open  either  directly  into  the 
mouth,  or  into  the  duct  of  Wharton.  These  several  openings  are  found 
along  the  bottom  of  the  mouth,  on  either  side  below  the  tongue. 

Several  small  salivary  granulations  or  glands  border  on  the  sublin- 
gual. Among  them  Dr.  Nuhn  has  designated  one  on  each  side  of  the 
tongue,  at  its  tip,  near  the  median  line,  just  below  the  ranine  artery, 
with  about  five  ducts ;  its  length  is  near  ten  lines,  and  its  breadth 
about  five,  sometimes  less.1 

The  position  of  the  salivary  glands  is  such,  that  they  are  much 
moved  and  pressed  upon  by  the  neighboring  parts  in  mastication,  inde- 
pendently of  the  emission  of  their  fluid  being  provoked  by  hunger. 
Owing  to  the  similitude  of  their  structure,  and  to  their  not  being  sup- 
plied like  other  glands  with  regular  capsules,  their  limits  are  occasion- 
ally so  inexact  that  they  continue  into  each  other  by  adjacent  points, 
and  form  thus  an  uninterrupted  chain.2 

They  are  all  of  the  conglomerate  kind,  or  consist  in  a  congeries  of 
smaller  glands  or  lobes  and  lobules.  When  the  duct  of  the  parotid  is 
injected  with  quicksilver,  the  latter  readily  finds  its  way  to  every  part 
of  the  gland,  and  the  ultimate  lobules  are  exhibited  as  small  spheri- 
form enlargements,  or  cysts  (acini).  The  substance  of  these  acini  is 
composed  of  small  closed  vesicles  made  of  structureless  membrane,  and 
which  by  dehiscence  or  laceration  discharge  into  the  adjoining  duct, 

'  Muller's  Archives,  1845. 

2  Bichat,  Anat.  Descrip.  vol.  v.  p.  24. 


496  ORGANS  OF  DIGESTION. 

each  containing  its  globule  of  mercury.  Each  having  its  little  duct, 
some  of  the  ducts  join  into  larger  branches,  the  successive  coalition  of 
which,  finally,  forms  the  principal  duct ;  others  of  them  are  so  closely 
upon  the  limits  of  the  latter,  that  they  discharge  directly  into  it.  In 
a  natural  state  these  cysts  are  compressed,  more  or  less,  by  one 
another,  but  the  tendency  of  the  mercury,  as  in  the  case  of  the  cells 
of  the  lungs,  is  to  dilate  them  into  the  spheroidal  shape.  The  same 
observations  are  applicable  to  all  the  salivary  glands.  These  glands  are 
well  furnished  with  arteries,  which  are  branches,  from  the  external 
carotid,  and  go  in  several  trunks  instead  of  in  a  leading  one.  The  paro- 
tid is  commonly  supplied  by  trunks  coming  directly  from  the  external 
carotid ;  the  submaxillary  is  supplied  from  the  facial  artery,  and  the 
sublingual  gland  from  the  lingual  artery.  Their  nerves  come  from 
the  fifth  pair,  and  from  the  portio  dura. 

The  retrograde  injection  of  their  excretory  ducts  shows  how  the 
ducts  are  formed  by  the  assembling  of  branches  from  the  different 
lobules.  These  ducts  consist  of  two  coats,  a  fibrous  one  externally, 
and  a  mucous  one  internally. 

The  form  in  which  a  salivary  gland  first  appears,  according  to 
Mliller  and  Weber,  is  that  of  a  simple  canal  with  bud-like  processes ; 
it  communicates  with  the  cavity  of  the  mouth,  and  reposes  in  a  gela- 
tinous nidus  or  blastema.  As  the  evolution  goes  on,  the  canal  is  more 
and  more  ramified,  while  the  quantity  of  the  germinal  mass  or  blaste- 
ma is  diminished.  The  blastema  afterwards  assumes  the  lobulated 
form  of  the  gland,  and  then  disappears  wholly.  Thus  in  their  earlier 
state,  the  salivary  ducts  can  be  seen  to  exist  as  a  closed  system  of 
ramified  tubes,  but,  finally,  in  the  perfect  state,  their  ccecal  or  peri- 
pheral extremities  being  highly  attenuated,  end  in  vesicles  which 
cluster  together  like  bunches  of  grapes.  This  arrangement  can  be 
well  seen  on  filling  the  parotid  gland  with  mercury  from  its  excretory 
duct.  The  most  minute  pulmonary  air-cells  are  from  five  to  sixteen 
times  larger  than  the  cells  of  the  parotid  gland,  and  the  latter  have  a 
.diameter  about  three  times  larger  than  the  capillaries  which  ramify 
upon  them.1 


CHAPTER  VI. 

OF   THE  PHARYNX  AND  (ESOPHAGUS. 
SECT.  I. — OF  THE  PHARYNX. 

THE  Pharynx  (yiharynx]  is  a  large  membranous  cavity  like  a  dis- 
placement funnel,  placed  between  the  cervical  vertebrae  and  the  poste- 
rior part  of  the  nose  and  mouth.  It  extends  from  the  base  of  the 
cranium  to  the  lower  part  of  the  cricoid  cartilage,  or  to  the  lower  part 

1  Mxiller,  vol  i.  448. 


THE  PHARYNX.  497 

of  the  fifth  cervical  vertebra.     It  is  in  contact,  "behind,  with  the  verte- 
brae and  the  muscles  lying  upon  them,  being  simply  attached  there  by 

Fig.  153. 


Median  section  of  the  Nose,  Mouth,  Pharynx,  and  Larynx,  a.  Septum  of  the  nose;  below  it,  is 
the  section  of  the  hard  palate,  b.  The  tongue,  c.  Section  of  velum  pendulum  palati.  d,  d.  Lips. 
«.  Uvula,  r.  Anterior  half  arch  or  pillar  of  fauces,  t.  Posterior  half  arch.  t.  Tonsil,  p.  Pharynx. 
h.  Hyoid  bone.  k.  Thyroid  cartilage,  n.  Cricoid  cartilage  s.  Epiglottis,  v.  Glottis.  1.  Posterior 
opening  of  nares.  3.  Isthmus  of  the  fauces.  4.  Superior  opening  of  larynx.  5.  Passage  into  oesopha- 
gus. 6.  Mouth  of  right  Eustachian  tube. 

loose  cellular  substance ;  above,  it  adheres  to  the  cuneiform  process  of 
the  os  occipitis  and  to  the  point  of  the  petrous  portion  of  the  temporal 
bones ;  in  front,  to  the  lower  part  of  the  internal  pterygoid  processes 
of  the  sphenoid  bone,  to  the  posterior  part  of  the  upper  and  of  the 
lower  maxilla  near  the  termination  of  their  alveolar  processes,  to  the 
cornua  of  the  os  hyoides,  the  side  of  the  thyroid  and  of  the  cricoid 
cartilage ;  and  below  it  is  continued  into  the  esophagus.  In  conse- 
quence of  these  several  attachments  the  pharynx  is  kept  open,  or  its 
sides  are  prevented  from  collapsing,  and  it  is  drawn  up  and  down  in 
the  motions  of  the  tongue  and  of  the  larynx. 

The  Pharynx  consists  in  three  coats:  an  external  one,  formed  by 
three  muscles,  on  each  side,  one  above  the  other,  and  called  constric- 
tors; an  intermediate  cellular  coat;  and  an  internal  mucous  one. 

1.  The  Musculus  Constrictor  Pharyngis  Inferior  arises  from  the 
side  of  the  cricoid,  and  from  the  whole  length  of  the  side  of  the  thy- 
roid cartilage.  From  these  points  its  fibres  diverge  to  the  middle 
vertical  line  on  the  back  of  the  pharynx,  where  they  join  with  their 
congeners  of  the  opposite  side.  The  lower  fibres  are  nearly  if  not 
completely  horizontal,  and  those  above  increase  successively  in  their 
tendency  upwards,  so  that  the  upper  ones  approach  more  and  more  a 
VOL.  i.~ 32 


498  ORGANS  OF  DIGESTION. 

vertical  direction,  and  finally  reach,  at  their  termination,  to  within 
twelve  or  fourteen  lines  of  the  upper  part  of  the  pharynx. 

2.  The  Constrictor  Pharyngis  Medius  arises  from  the  cornu  and 
appendix  of  the  os  hyoides,  and  from  the  ligament  connecting  the 
posterior  end  of  the  latter  with  the  upper  cornu  of  the  thyroid  carti- 
lage.    Its  inferior  margin  is  overlapped  by  the  superior  margin  of  the 
last ;  its  fibres  there  are  also  horizontal,  and,  indeed,  somewhat  convex 
downwards ;  while  the  superior  fibres  become  successively  more  oblique 
in  ascending.     It  is  inserted  by  the  middle  line  behind,  into  its  fellow 
of  the  opposite  side ;  and  by  its  point  above  into  the  cuneiform  process 
of  the  os  occipitis,  just  in  advance  of  the  recti  majores  muscles. 

3.  The  Constrictor  Pharyngis  Superior  arises  from  the  lower  part 
of  the  internal  pterygoid  process  of  the  sphenoid  bone,  and  below  that 
from  the  back  part  of  the  upper  and  of  the  under  jaw  behind  the  last 
molar  tooth ;  it  is  also  connected  at  its  anterior  margin  with  the  buc- 
cinator muscle,  and  with  the  root  of  the  tongue  between  the  anterior 
and  the  posterior  half  arches  of  the  palate,  being  blended  there  with 
the  transverse  fasciculus  of  the  stylo-glossus  muscle.     It  has  its  lower 
edge  overlapped  by  the  constrictor  medius;  and  its  fibres  are  more 
horizontal,  generally,  than  those  of  the  preceding  muscles.     It  is  in- 
serted into  its  fellow  by  a  middle  line,  the  upper  end  of  which  adheres 
to  the  cuneiform  process  of  the  os  occipitis.     The  superior  margin  of 
this  muscle  between  the  pterygoid  process  of  the  sphenoid  and  the 
cuneiform  process  of  the  occipital  makes  a  crescentic  line,  the  con- 
cavity of  which  is  upwards. 

The  constrictor  muscles  of  the  pharynx,  by  their  successive  contrac- 
tion, convey  the  food  from  the  mouth  into  the  (esophagus. 

4.  The  Stylo-Pharyngeus,  which  is  mentioned  among  the  muscles  of 
the  neck,  forms  an  interesting  portion  of  the  structure  of  the  pharynx, 
and  may  be  considered  on  a  footing  with  the  longitudinal  fibres  of  the 
oesophagus  and  of  the  intestines.    It  is  intended  to  shorten  the  pharynx 
by  arising  from,  or  having  a  fixed  point  at  the  styloid  process  above, 
and  by  being  joined  into  the  pharynx  below.     Its  fibres  being  first  of 
all  on  the  outside  of  the  upper  constrictor,  are  readily  traced  between 
the  lining  membrane  and  the  two  lower  constrictors  to  the  posterior 
margin  of  the  thyroid  cartilage  ;  into  which  margin,  after  spreading  out, 
they  are  finally  inserted,  more  particularly  into  the  cornu  major. 

5.  The  Palato-pharyngeus  is  also  an  important  muscle  of  the  pharynx, 
and  can  not  be  well  understood,  except  by  raising  from  its  posterior 
face  all  the  constrictor  muscles  of  the  pharynx.     It  will  then  be  seen 
that  it  spreads  out  very  much  like  the  wing  of  a  butterfly,  the  shorter 
part  being  up,  and  there  running  almost  horizontally  within  the  upper 
constrictor.    The  fibres  generally  radiate  from  the  soft  palate,  so  as  to 
make  an  internal  muscular  coat  for  almost  the  entire  of  the  correspond- 
ing half  of  the  pharynx,  and  in  that  way  reach  the  middle  line  of  the 
latter.    The  anterior  margin  is  attached  to  the  posterior  margin  of  the 


THE  PHARYNX.  499 

thyroid  cartilage ;  and  the  muscle  ends  below  on  a  level  with  the  cri- 
coid  cartilage  by  insertion  into  the  tunica  propria  of  the  pharynx.  The 
stylo-pharyngeus  is  by  no  means  so  extensive,  and  its  principal  termi- 
nation is  in  the  posterior  part  of  the  thyro-hyoid  membrane,  and  in 
the  thyroid  cartilage  at  or  near  the  cornu  major.  It  is  placed  in  front 
of  the  palato-pharyngeus,  but  the  edges  of  the  two  blend  together,  so 
that  the  distinction  is  very  much  lost. 

The  Intermediate  membrane  (tunica  propria)  of  the  pharynx  is 
merely  a  thin  layer  of  filamentous  cellular  tissue,  destitute  of  fat,  as  in 
the  hollow  viscera  elsewhere;  and  which  joins  the  muscular  to  the 
mucous  coat. 

The  Internal  or  Mucous  Membrane  of  the  pharynx,  which  lines  the 
last,  is  spread  uniformly  over  it ;  the  only  irregularity  of  its  surface 
being  made  by  the  presence  of  mucous  follicles  and  glands,  which  are 
more  abundant  above  between  the  posterior  margins  of  the  two  stylo- 
Fig.  154. 


View  of  the  Muscular  Structure  of  the  Pharynx  from  behind.  The  three  constrictors  are  raised 
up  from  their  origin  and  turned  over  to  the  left. — 1.  Constrictor  superior.  2  Constrictor  medius. 
3.  Constrictor  inferior.  4.  Stylo-pharyngeus.  5,  5.  Palato-pharyngeus.  6.  CEsophagus.  7.  Stylo- 
hyoideus  and  digastricus.  8.  Os  hyoides.  9.  Posterior  margin  of  the  thyroid  cartilage.  10.  Trachea. 

pharyngei  than  below.  It  is  covered  by  a  very  delicate  epidermis,  and 
is  supplied  with  two  arteries  on  each  side,  the  superior  and  inferior 
pharyngeal ;  the  first  of  which  comes  from  the  internal  maxillary,  and 
the  second  from  the  external  carotid.  It  exhibits  a  number  of  small 
veins,  which  run  into  the  internal  jugular  or  some  of  its  branches. 
The  shape  of  the  cavity  of  the  pharynx  is  oblong  and  cylindrical, 


500  ORGANS  OP  DIGESTION. 

being  somewhat  larger  at  its  superior  end.  At  the  latter  place,  where 
it  is  attached  to  the  petrous  bone,  it  presents  a  deep  corner,  which 
gives  it  a  square  appearance  there,  and  has  a  collection  of  muciparous 
follicles  somewhat  like  the  tonsil  gland.  Anteriorly,  and  above,  it  is 
continuous  with  the  Eustachian  tubes,  and  with  the  posterior  nares ; 
just  below  this,  with  the  fauces  and  mouth;  and  below  the  root  of  the 
tongue  with  the  cavity  of  the  glottis  or  larynx.  At  its  lower  extremity, 
where  it  terminates  in  the  oesophagus,  it  is  so  contracted  as  to  suit  the 
size  of  the  latter  cavity. 


SECT.  II. — OF  THE  (ESOPHAGUS. 

The  oesophagus  is  the  tube  just  in  front  of  the  spine  and  behind  the 
trachea,  which  conducts  food  from  the  pharynx  into  the  stomach.  When 
inflated  it  is  of  a  cylindroid  shape,  about  ten  or  twelve  lines  in  dia- 
meter ;  it  is  nine  or  ten  inches  long  and  gradually  increases  in  its  size 
from  above  downwards  ;  in  its  state  of  repose  it  is  flattened  from  before 
backwards.  Its  descent  is  not  entirely  vertical,  but  at  the  lower  part 
of  the  neck  it  inclines  somewhat  to  the  left  of  the  middle  line,  and  is, 
therefore,  rather  to  the  left  side  of  the  trachea  than  behind  it.  It  passes 
down  the  thorax  in  the  posterior  mediastinum,  being  bounded  on  its  left 
side  by  the  aorta,  and  on  the  right  by  the  vena  azygos.  It  keeps,  dur- 
ing the  early  part  of  its  course  in  this  cavity,  in  front  of  the  middle 
line  of  the  spine ;  but  lower  down  it  inclines  again  slightly  to  the  left 
side,  in  front  of  the  aorta,  in  order  to  reach  the  cesophageal  orifice  of 
the  diaphragm,  through  which  it  penetrates  into  the  abdomen.  In  all 
this  passage  the  oesophagus  is  united  to  adjacent  parts  by  a  loose  cel- 
lular tissue. 

The  oesophagus  is  composed  of  three  coats  :  the  muscular ;  the  cel- 
lular or  nervous ;  and  the  mucous. 

The  Muscular  Coat  is  the  external,  and  very  strong.  It  consists  in 
two  well  marked  laminae  of  muscular  fibres.  The  most  exterior  is  the 
thickest,  and  goes,  longitudinally  from  one  end  to  the  other  of  the  tube  ; 
commencing  according  to  J.  F.  Meckel,  by  three  fasciculi  above ;  one 
of  which  arises,  tendinously,  from  the  posterior  face  of  the  cricoid  car- 
tilage, and  the  other  two,  one  on  each  side,  from  the  inferior  constrictor 
of  the  pharynx.  These  fasciculi  descend  for  an  inch  or  two,  before 
they  spread  out  into  a  uniform  membrane.  The  internal  muscular 
lamina  consists  in  circular  fibres,  which  may  be  considered  as  a  con- 
tinuation of  the  lower  margin  of  the  inferior  constrictor  of  the  pharynx, 
and  are  either  horizontal  or  slightly  spiral ;  they  are  rather  deficient 
on  the  fore  part  of  the  oesophagus  for  an  inch  at  its  superior  extremity. 
Individually,  their  length  is  short  of  the  circumference  of  the  oeso- 
phagus. 

The  Cellular  Coat  (tunica  propria)  is  next  in  order.  It  is  much 
thicker  and  stronger  than  that  of  the  pharynx,  making  a  layer  which 
is  very  easily  raised  as  a  distinct  coat,  and  is  filamentous.  It  serves  to 


THE  (ESOPHAGUS.  501 

unite  the  muscular  and  the  mucous  together.  It  adheres  much  more 
closely  to  the  latter  than  it  does  to  the  former,  has  no  adipose  matter 
in  it,  but  is  found  to  be  abundantly  furnished,  more  particularly  towards 
its  upper  end,  with  small  muciparous  glands;  it  also  serves  to  transmit 
the  blood-vessels  through  the  structure  of  the  oesophagus. 

The  Mucous  Coat  of  the  oesophagus  is  the  most  internal ;  in  the  un- 
distended  state  it  always  presents  many  longitudinal  folds,  going  from 
one  end  to  the  other,  but  sometimes  blending  with  each  other,  owing  to 
the  contraction  of  the  circular  muscular  fibres.  When  suspended  in 
water,  its  fine  villous  appearance  is  very  perceptible,  as  well  as  the 
mucous  lacunae  or  glands  which  open  upon  its  internal  surface.  As  it 
is  a  continuation  of  the  mucous  membrane  of  the  pharynx,  it  has  the 
same  general  appearance,  but  is  rather  whiter.  Its  internal  surface  is 
also  covered  by  a  delicate  epidermis,  which  ceases  at  the  cardiac  orifice 
of  the  stomach,  and  may  be  raised  in  shreds  by  maceration  and  by 
boiling.  In  some  pathological  conditions  this  epidermis  becomes  very 
distinct  by  acquiring  more  thickness  and  solidity  than  what  belongs  to 
its  healthy  state. 

The  arteries  of  the  oesophagus  are  derived  from  the  inferior  thyroidal, 
from  the  thoracic  aorta,  and  from  the  gastric.  Its  nerves  come  princi- 
pally from  the  pneumogastric. 

Prof.  Hyrtl,  of  Vienna,  has  described  two  muscles  in  connection  with 
the  oesophagus,  which  he  calls  broncho-oesophageal,  and  pleuro-cesopha- 
geal.  The  first  is  higher,  arises  by  a  broad  base  from  the  posterior  face 
of  the  left  bronchus,  #hd  is  inserted  into  the  left  side  of  the  oesophagus, 
by  mingling  with  its  longitudinal  fibres  for  two  or  three  inches.  The 
other  arises  on  the  left  side  from  the  posterior  mediastinum,  behind  the 
aorta,  and  turns  around  the  latter  to  reach  the  oesophagus.  The  first  is 
supposed  to  give  more  fixedness  to  the  left  bronchus,  and  the  other  to 
do  the  same  for  the  oesophagus.1  These  muscles  are  rather  rare ;  in  a 
recent  dissection,  however,  at  the  University,2  I  met  with  a  specimen 
of  them  very  much  as  described. 

1  Br.  and  For.  Med.  Rev.  p.  269.     Jan.  1845. 

2  Feb.  11,  1851. 


INDEX    TO    VOL.    I. 


Abdomen,  Muscles  of,  386 
Abdominal  Canal,  394 
Fascia,  386 
Rings,  388 
Abductor  Indicis,  455 

Manus,  429 
Min.  Digit.,  455 

Pedis,  429 
Pollicis  Manus,  427 
Pedis,  454 
Acetabulum,  127 

Acromio-Clavicular  Articulation,  287 
Adductor  Metacarpi  Min.  Digiti,  430 
Pollicis  Manus,  429 
Pedis,  454 
Femoris,  441 
Adeps,  323 

Adipose  Substance,  323 
Alare  Majus  Ligament,  306 
Minus  Ligament,  306 
Alimentary  Canal,  457 
Alveolar  Processes,  168 
American  Indian,  145 
Anconeus,  417 
Anguli  Oris  Levat,  373 
Animal  Substance  in  Bones,  85 

Life,  Muscles  of,  355 
Ankle  Joint,  308 

Ligament  of    (Ligament  Annu- 
lare),  435 
Annularis,  214 

Annuli  Junct.  Ligamentosi,  422 
Anterior  Articulation  of  Ribs,  284 

Vertebral  Lig.,  271 
Anomalus  Faciei,  373 
Antrum  Highmorianum,  160 
Aponeurosis  Dorsalis  Ped.,  435 
Palmaris,  412 
Plantaris,  436 
Arm  Bone,  201 

Muscles  of,  415 
Articulations,  267 

Atlas,  275 

Carpo-Metacarpal,  297 
Carpus,  295 


Articulations,  Elbow,  290 
Foot,  30.9 
Ilio-Femoral,  300 
Individual,  267 
Lower  Extremities,  300 

Jaw,  267 
Metacarpo-Phalangial, 

298 

Metatarsal,  313 
Peroneo-Tibial,  307 
Phalangial,  299 
Pubes,  281 
Radio-Ulnar,  293 
Shoulder,  286 
Spinous  Processes,  273 
Sterno-Clavicular,  286 
Tarsal,  309 
Tarso-Metatarsal,  312 
Thorax,  282 
Toes,  314 

Upper  Extremities,  286 
Wrist,  293 

Areolar  Tissue,  315 

Arteria  ad  Cutem  Abdom.,  386 

Arteries  of  Bones,  88 

Articular  Cartilages,  263 

Astragalus,  235 

Atlas,  110 

Auricularis,  214 

Azygos  Uvulae,  491 

Bartholin,  Duct  of,  495 

Belchier  on  Madder,  101 

Biceps  Flexor  Cubiti,  415 
Cruris,  445 

Bifid  Ligament,  288 

Bile,  57 

Body,  Composition  of,  48 

Bones,  74 

Arteries  of,  88 
Broad,  74 
Calcific  Stage,  95 
Canals  of  Deutsch,  80 
Cartilaginous  Stage,  94 
Cellular  Structure  of,  76 


504 


INDEX  TO  VOL.  I. 


Bones,  Compact  Substance  of,  75 

Composition  of,  83 

Corpuscles  of  Purkinje,  79 

Density  of,  75 

Development  of,  94 

Fibres  of,  87 

Growth  of,  98  _ 

Haversian  Ossicle,  79 

Canals  in,  79 

Histology  of,  74 

Individual,  105 

Lamellse  of,  78 

Long,  74 

Lymphatics  of,  90 

Madder  in  Bones,  101 

Mucous  Stage  of,  94 

Nerves  of,  90 

Number  and  Texture  of,  74,  106 

of  Trunk,  106 

Organization  of,  88 

Physick's-  Experiments  on,  83 

Keticulated  Structure,  77 

Shape  of,  74 

Texture  of,  74 

Thick,  74 

Tubuli  Calcigeri,  79 

Vascularity  of,  89 

Veins  of,  89 
Brachial  Fascia,  410 
Brachialis  Internus,  416 
Brachio-Radial  Ligament,  291 
Buccinator,  375 

Calcaneo-Cuboid  Ligament,  311 

Scaphoid  Ligament,  310 
Calcis  Os,  234 
Callus,  102 
Camper,  189 
Capsular  Ligaments,  263 
Carotid  Canal,  153 
Carpal  Articulation,  293 
Carpus,  207 
Cartilage,  Semilunar,  305 

Xyphoid,  136 
Cartilages,  253 

Accidental,  257 

Articular,  336 

of  Ribs,  137 

Cartilaginous  System,  253 
Casein,  51 

Caucasian  Race,  190 
Cells,  Elementary,  65 
Cellular  Substance,  315 

of  Bones,  76 
Structure  of  Bones,  76 
Cement  of  Teeth,  467 
Cervicalis  Descendens,  406 
Cervical  Vertebras,  109 
Cheek  Bones,  165 
Chin,  168 
Cholesterin,  60 
Chondrin,  56 
Cilia,  69 


Ciliaris,  372 

Classification  of  Tissues,  34 

Clavicle,  200 

Clavicular  Ligaments,  288 

Coccygeal  Ligaments,  279  » 

Coccyx,  117 

Colla,  56 

Compact  Substance  of  Bones,  75 

Complexus,  407 

Composition  of  Body,  48 

Compressor  Naris,  371 

Concha  Morgagni,  157 

Conoid  Ligament,  288 

Consolidation  of  Fractures,  102 

Constrictor  Isthmi  Faucium,  490 

Pharyngis  Inferior,  497 
Medius,  498 
Superior,  498 
Coraco-Acromial  Ligament,  289 

Brachialis  Muscle,  416 
Corium,  328 
Coronal  Suture,  172 
Corpuscles  of  Purkinje",  79 
Corrugator  Supercilii,  373 
Costse,  132 

Costo-Transverse  Ligament,  283 
Cotyloid  Cavity,  127 

Ligament,  300 
Cranium,  143 

Base  of,  178 

External  Surface  of,  180 
Internal  Surface  of,  178 
Vault  of,  178 
Cremaster,  393 
Crista  Frontalis,  178 

Nasalis,  167 

Turbinalis,  166 
Crucial  Ligaments,  305 
Crurseus,  439 
Crural  Arch,  387 

Fascia,  436 

Ring,  401 

Crusta  Petrosa,  467 
Cubitus,  203 
Cuboides,  238 
Cucullaris,  401 
Cuneiforme,  208 
Cuneiform  Bones,  236,  237 
Cuticle,  335 
Cutis,  327 

Vera,  328 
Cytoblast,  53 
Cytoblastema,  319 

Dacryolin,  54 

Deciduous  Teeth,  476 

Deltoid  Ligament,  308 

Deltoides,413 

Demodex  Folliculorum,  339 

Dental  Cartilage,  475 

Glands,  475 
Dentata,  110 
Dentine,  465 


INDEX  TO  VOL.  I. 


505 


Dentition,  476 

Irregularities  of,  481 
Depressor  Anguli  Oris,  374 
Labii  Infer.,  374 
Sup.,  374 

Dermoid  Tissue,  327 
Desmoid  Tissue,  258 
Deutsch,  Canals  of,  81 
Development  of  Bones,  94 

Foetal  Head,  193 
Pelvis,  130 

Vertebral  Column,  118 
Diameters  of  Foetal  Head,  195 
Diaphragm,  396 
Diaphysis,  75 
Digastricus,  380 
Digestion,  Organs  of,  457 
Dilatans  Nasi,  372 
Diploe  of  Head,  170 
Dorsal  Vertebrae,  112 
Duct  of  Bartholin,  495 
Steno,  494 
Wharton,  494 
Ductus  Riviniani,  495 
Duhamel,  101 

Earthy  Matter  of  Bones,  84 
Elain,  324 
Elbow  Joint,  290 
Elementary  Cells,  65 
Emissaries  of  Santorini,  171 
Enamel,  463 
Ensiforin  Cartilage,  136 
Epidermic  Cells,  336 
Epidermis,  335 
Epiphyses,  74 
Ethmoides,  156 

Extensor  Brev.  Digit.  Pedis,  452 
Carp.  Rad.  Brev.,  424 
Long.,  423 
Ulnaris,  424 
Digit.  Com.,  424 
Long.  Digit.  Pedis,  447 
Metacarpi  Pollicis,  425 
Pollicis  Minor  et  Major,  426 
Prop.  Poll.  Pedis,  448 
External  Cellular  Tissue,  320 

Transverse  Ligament,  268 
Extractiform  Substances,  55 
Extremities,  Development  of,  215,  241 
General  Motions  of,  250 
Inferior,  223 
Mechanism  of,  216,  242 
Superior,  197 

Face,  143,  158,  187 
Facial  Angle,  187 
Fascia  Brachialis,  410 
Fascia  Cruralis,  434 

Iliaca,  401 

Lata  Femoris,  432 

of  Hand,  412 

of  Hip,  432 


Fascia  Lumborum,  390 

Profunda  Colli,  378 
Spermatica,  388 
Superficialis  Abdominis,  386 

Colli,  376 

Transversalis  Abdom.,  393 
Fasciae  of  Foot,  436 

of  Lower  Extremities,  432 
of  Upper  Extremities,  410 
Fat,  323 

Femoral  Ring,  401 
Femoris,  Os,  223 
Fibrin,  51 

Fibro-Cartilaginous  System,  262 
Fibula,  230 
Finger  Joints,  299 
Flexor  Accessorius,  453 

Brev.  Digit.  Pedis,  452 

Pedis,  428 
Poll.  Manus,  454 
Carpi  Radialis,  419 
Ulnaris,  419 
Digitorum  Profund.,  420 

Subl.,  420 
Long.  Digit.  Pedis,  450 

Poll.  Pedis,  451 
Min.  Digit.  Pedis,  455 
Parv.  Min.  Digit,  429 
Pollicis  Longus,  421 
Foetal  Head,  193 
Fontanels,  194 
Foot,  Articulations  of,  309 
Bones  of,  233 
Motions  of,  249 
Muscles  of,  452 
Foramen  Aorticum,  398 

(Esophageum,  397 
Quadratum,  397 
Thyroid,  127 
Fore  Arm,  203 

Articulations  of,  290 
Motions  of,  219 
Muscles  of,  418 
Formation  of  Callus,  102 
Frenulae  of  Mouth,  459 
Frontal  Bone,  145 
Frontalis  Muscle,  371 

Gagliardi  on  Bones,  86 
Gastrocnemius,  449 
Gaultier,  331 
Gemini,  444 
Gemmula,  331 
Genio-Hyoideus,  381 

Hyo-Glossus,  484 
Gimbernat's  Ligament,  391 
Glands  of  Havers,  266 

Salivary,  493 
Glandulae  Linguales,  492 

Mucip.,  493 
Glenoid  Cavity  of  Scapula,  200 

Ligament,  290 
Globulin,  53 


506 


INDEX  TO  VOL.  I. 


Glue,  56 

Glutaeus  Magnus,  442 

Medius,  442 

Minimus,  443 
Glycerin,  61 
Gracilis,  439 

Gubernaculum  Dentis,  463 
Gums,  470 
Guttural  Region,  180 

Haematin,  57 
Hand,  Bones  of,  207 
Motions  of,  221 
Muscles  of,  478 
Hairs,  347 

Half  Arches,  of  Palate,  490 
Havers,  Glands  of,  266 
Haversian  Canals,  79 
Ossicle,  81 
Head,  43 

Development  of  Foetal,  193 
External  Surface  of,  180 
General  Considerations  on,  170 
Hey's  Ligament,  434 
Hiatus  Aorticus,  398 
Hip  Joint,  300 
Histogeny,  53 
Histology,  33 

of  Bones,  74 
Body,  33 
Cartilage,  253 
Cellular  Substance,  315 
Fibro-Ligaments,  262 
Ligaments,  258 
Human  Races,  190 
Humeral  Bone,  201 
Hunter  on  Bones,  101 
Hyaline,  68 
Hyoides,  196 

Iliac  Fossa,  125 
Iliacus  Internus,  400 
Ilio-Femoral  Articulation,  300 

Lumbar  Ligament,  280 
Ilium,  123 
Impudicus,  214 
Incisura  Jugularis,  151 
Indians,  191 
Indicator,  426 
Individual  Bones,  105 
Inferior  Extremities,  223,  241 

in  Locomotion,  247 
in  Standing,  242 

Maxilla,  167 

Palmar  Ligaments,  298 

Spongy  Bones,  166 
Infra-Spinatus  Scapulae,  413 
Innominata,  123 
Integuments,  315 
Inter-Clavicular  Ligament,  286' 
Inter-Maxillary  Bone,  161 
Inter-Pubic  Ligament,  282 
Inter-Spinales,  409 


Inter-Transversarii,  409 

Intercostales,  385 

Interosseous  Ligament  of  Fore  Arm,  292 

of  Leg,  308 
Muscles  of  Foot,  455 
Hand,  431 

Internal  Abdominal  Ring,  394 

Cellular  Membrane,  321 
Transverse  Ligament,  283 

Intervertebral  Substance,  270 

Introduction,  33 

Involucrum  of  Knee,  303-409 

Ischium,  125 

Itinera  Dentium,  479 

Ivory  of  Teeth,  465 

Jaw  Bone,  Lower,  167 
Upper,  159 
Joints,  263 

Keratin,  55 
Knee  Joint,  303 

Lacerti  Ligamentosi,  276 
Lachrymal  Fossa,  187 
Matter,  54 
Lactic  Acid,  59 
Lambdoidal  Suture,  173 
Lamellae  of  Bone,  78 
Lateral  Lig.  of  Knee,  344 
Latissimus  Dorsi,  403 
Leg,  Bones  of,  227 
Motions  of,  248 
Muscles  of,  446 
Lepidosteus,  Scale  of,  82 
Levator  Anguli  Oris,  373 

Labii  Inferioris,  seu  Menti,  374 

Sup.,  373 
Palati,  491 

Pharyngis  Internus,  490 
Scapulae,  405 
Levatores  Costarum,  409 
Life,  Organic,  43 
Ligament,  Glenoid,  290 
of  Patella,  304 
of  Poupart,  387 
ofWinslpw,  304 
Ligamenta  Vaginalia,  422 
Ligamentous  Tissue,  258 
Ligaments,  Capsular,  263 
Funicular,  263 
of  Bodies  of  Vertebras,  270 
of  Joints,  263 
of  Pelvis,  279 
of  Processes    of   Vertebrae, 

278     • 

of  Spine,  270 
Strength  of,  260 
Texture,  258 
Yellow,  274 
Ligamentum  Alaria,  306 

Annulare  of  Ankle,  435 
Arcuatuin,  399 


INDEX  TO  VOL.  I. 


507 


Ligamentum  Bicorne,  288 

Carpi  Dorsale,  411 
V olare,  412 
Coracoideum,  289 
Dentis,  463 
Laciniatum,  436 
Maxill.  Infer.,  267 
Mucosum,  306 
Nuchse,  374 
Pubic.  Sup.,  391 
Teres,  300 
Linea  Alba,  387 

Semilunaris,  388 
Transversa,  388 
Lingualis,  485 
Lips,  459 

Longissimus  Dorsi,  405 
Longus  Colli,  382 
Lower  Jaw  Articulation,  267 

Bone,  167 
Extremities,  Joints  of,  300 

Motions  of,  247,  250 
Lumbar  Vertebrae,  114 
Lumbricales  Manus,  427 

Pedis,  453 
Lunare,  208 
Lymphatics  of  Bones,  90 

Mafdder,  101 
Magnum,  210 
Malpighi  on  Bones,  86 
Margaric  Acid,  61 
Margarin,  324 
Marrow,  92 
Mass^ter,  375 

Mastication,  Organs  of,  458 
Mastodon  Bones,  84 
Maxillare,  Articulation  of,  267 
Inferius,  167 
Superius,  159 
Mechanism  of  Joints,  263 
of  Pelvis,  131 
Meckel  on  Bones,  86 
Medulla,  92 

Medullary  Membrane,  93 
Membrana  Musculorum,  354 
Metacarpal  Joints,  297 
Metacarpus,  211 
Metatarsal  Joints,  313 
Metatarsus,  238 

Middle  Straight  Ligaments,  277 
Moderator  Ligament,  277 
Mongolian  Race,  190 
Mouth,  458 

Glands  of,  492 
Mucous  Tissue,  317 
Muciparous  Glands,  492 
Mucus,  54 

Multifidus  Spinge,  408 
Muscles  and  Fascia  of  Abdomen,  386 

Chemical  Analysis  of,  361 

Histology  of,  353 

of  Animal  Life,  355 


Muscles  of  Arm,  415 

of  Back,  401 

of  Face,  370 

of  Fore  Arm,  418 

of  Front  of  Thorax,  384 

of  Head  and  Neck,  370 

of  Leg,  446 

of  Neck,  376 

of  Organic  Life,  362 

of  Shoulder,  413 

Shape  and  Arrangement  of,  367 

Special  Anatomy  of,  370 

Structure  of,  354 

of  Thigh,  437 

of  Trunk,  384-401 
Muscular  Fibre,  355 

Motion,  363 
Musculus  Cutaneus,  377 

Risorius,  377 
Mylo-Hyoideus,  381 
Myolemma,  355 

Nails,  345 
Nasal  Bones,  163 

Cavities,  184 
Naviculare,  235 
Negroes,  190 
Nerves  of  Bones,  90 
Nucleoli,  53 
Nucleus,  53 

Obliquus   Capitis    (Superior    et     Infe- 
rior), 409 

Ext.  Abdominis,  387 
Int.  Abdominis,  389 
Obturator  Externus,  445 
Internus,  444 
Ligament,  281 
Occipital  Bone,  148 

Region,  180 

Occipitalis  Musculus,  371 
Occipito-Frontalis,  370 

Vertebral  Articulation,  275 
Odoriferous  Organs,  342 
(Esophagus,  500 
Oleic  Acid,  61 
Omo-Hyoideus,  380 
Opponens  Pollicis,  428 
Orbicularis  Oris,  375 

Palpebrarum,  372 
Orbicular  Ligament,  292 
Orbits,  185 
Organic  Life,  43 
Organization  of  Bones,  88 
Os  Coccygis,  117 
Hyoides,  196 
Planum,  137 
Pubis,  125 
Unguis,  164 
Ossa  Innominata,  123 

Longa,  Lata,  Crassa,  97 
Palati,  161 
Ossification,  97 


508 


INDEX  TO  VOL.  I. 


Osteogeny,  94 
Osteophyte,  102 
Ovalis  Linguae,  485 

Palate  Bones,  161 

Muscles  of,  489 
Soft,  489 

Palatine  Region,  180 
Palmar  Ligaments,  298 
Palmaris  Brevis,  427 
Longus,  419 
Papillae  of  Tongue,  487 

Tactus,  329 
Parietal  Bones,  147 
Parotid  Gland,  493 
Patella,  232 
Pectinalis,  440 
Pectineal  Fascia,  433 
Pectoralis  Major,  384 
Minor,  384 
Pellis,  327 
Pelvic  Vertebrae,  115 
Pelvis,  128 

Development  of,  130 
Diameters  of,  129 
Ligaments  of,  279 
Male  and  Female,  129 
Mechanism  of,  131 
Straits  of,  128 
Penil,  387 
Pepsin,  52 
Perichondrium,  257 
Periosteum  Externum,  90 
Internum,  92 
Peroneus  Brevis,  448 
Longus,  448 
Tertius,  417 

Peroneo-Tibial  Articulations,  307 
Perspiratory  Organs,  340 
Phalanges  of  Foot,  241 

of  Hand,  213 

Phalangial  Articulations,  299 
Pharynx,  496 

Muscles  of,  497 
Physick,  Dr.,  Experiments  on  Bones,  83 
Pigment  Cells,  334 
Pisiforme,  209 
Plantaris,  450 
Plantar  Ligament,  313 
Platysma  Myoides,  377 
Plica  Polonica,  351 
Ploughshare,  166 
Popliteus,  450 
Pollex,  214 
Posterior  Indicis,  430 
Poupart's  Ligament,  387 
Prior  Indicis,  430 
Pronator  Radii  Teres,  418 

Quadratus,  422 
Protein,  50 
Psoas  Magnus,  400 

Parvus,  400 
Pterygoideus  Externus,  376 


IHerygoideus  Internus,  376 
rHerygo-Maxillary  Fossa,  183 
Pubes,  125 
Pubic  Ligament,  282 
Pulp  of  Tooth,  471 
Punctum  Ossificationis,  97 
Purkinje,  Corpuscles  of,  79 
Pyin,  56 

Pyramidalis,  391 
Pyramids  of  Wistar,  158 
Pyriformis,  444 

Quadratus  Femoris,  444 

Lumborum,  399 
Quadriceps  Femoris,  439 

Radio-Carpal  Articulation,  293 
Ulnar  Articulation,  293 

Rachis,  106 

Radius,  205 

Rectus  Abdominis,  391 

Capitis  Antic.,  382 
Lateral.,  383 
Postic.,  407 
Femoris,  438 

Rete  Mucosum,  331 

Rhomboideus  Major,  404 
Minor,  404 

Ribs,  132 

Articulation  of,  282 
Cartilages  of,  137 

Rings,  Abdominal,  394-388 

Rotatores  Dorsi,  410 

Round  Ligament,  293 

• 

Sacciform  Ligament,  293 

Sacro-Iliac  Articulation,  280 

Ligament,  280 
Lumbalis,  405 
Sciatic  Ligaments,  281 
Spinous  Ligament,  280 
Vertebral  Lig.,  279 

Sacrum,  115 

Sagittal  Suture,  173 

Salivary  Glands,  493 

Sarcocele,  66 

Sarcolemma,  355 

Sartorius,  437 

Scaleni,  383 

Scaphoides,  208 

Scapula,  198 

Scarpa  on  Bones,  87 

Scapulo-Clavicular  Articulations,  287 
Humeral  Articulations,  289 

Scythians,  191 

Sebaceous  Organs,  339 

Sella  Turcica,  154 

Semilunar  Cartilages,  305 

Semi-membranosus,  446 

Semi-spinalis  Cervicis,  407 
Dorsi,  408 

Semi-tendinosus,  445 

Sensation,  39 


INDEX  TO  VOL.  I. 


500 


Serratus  Inferior  Posticus,  404 
Magnus,  385 
Superior  Posticus,  404 
Sesamoid  Bones,  214 
Shoulder,  197 

Articulations  of,  286 
Motions  of,  217 
Muscles  of,  413 
Sight,  41 
Skeleton,  Anatomy  of,  73 

Regional  Division  of,  73 
Skin,  327 
Soleus,  449 
Spermatin,  53 
Spongiosum  Inferius,  176 
Sphenoides,  153 
Spinalis  Dorsi,  406 
Spinal  Ligaments,  270 
Spina  Mentalis,  167 
Spine,  106 

Ligaments  of,  270 
Uses  of,  110 
Splenius,  404 
Squamous  Suture,  173 
Stearin,  324 

Sterno-Cleido-Mastoideus,  377 
Hyoideus,  379 
Thyroideus,  379 
Sternum,  135 
Steno's  Duct,  944 
Stylo-Glossus,  381 
Hyoideus,  381 
Maxillary  Ligament,  379 
Pharyngeus,  381 
Subclavius,  385 
Sublingual  Gland,  495 
Submaxillary  Gland,  494 
Subscapularis,  414 
Sugar  of  Milk,  58 
Superior  Maxilla,  159 

Pubic  Lig.,  391 
Supinator  Had.  Brev.,  425 
Long.,  423 

Supra-Spinatus  Scapulae,  413 
Sutures,  Formation  of,  176 
of  Head,  173 
Use  of,  175 
Synovia,  267 
Synovial  Capsules,  265 
Symphysis  Pubis,  126 

Tarso-Metatarsal  Articulations,  312 
Tarsus,  233 
Taste,  41 
Teeth,  460 

Cavity  of,  468 

Chemical  Composition  of,  498 

Evoiution  of,  470 

Theories  of,  474 
Temporal  Bone,  150 
Temporalis,  375 
Temporis,  Os,  150 
Tendo-Achillis,  449 


Tendons,  368 
Tensor  Palati,  490 

Vaginae  Femoris,  437 
Ceres  Major,  414 
Minor,  414 
Texture  and  Organization  of  Teeth,  463 
Thigh  Bone,  223 

Motions  of,  247 
Muscles  of,  437 
Thorax,  132 

Articulations  of,  282 
Development  of,  138 
Mechanism  of,  140 
Thumb,  214 

Thyro-Hyoideus  Muscle,  380 
Tibia,  227 

Tibialis  Anticus,  446 
Posticus,  451 
Tissues,  Classification  of,  34 
Toes,  Bones  of,  240 
Joints  of,  345 
Tongue,  483 

Mucous  Covering  of,  486 
Muscles  of,  484 
Tonsils,  492 
Touch,  39 

Trachelo-Mastoideus,  407 
Transversalis  Abdominis,  390 
Cervicis,  407 
Fascia,  393 
^Pedis,  455 
Transverse  Ligament,  277 
Trapezium,  209 
Trapezius,  401 
Trapezoid  Ligament,  288 
Trapezoides,  209 

Triangular  Ligament  of  Scapula,  289 
Triangularis  Sterni,  386 
Triceps  Extensor  Cubiti,  417 

Surse,  449 
Triquetra,  174 
True  Skin,  328 
Trunk,  Bones  of,  106 

Muscles  of,  384 
of  Skeleton,  106 
Tubuli  Calcigeri,  79 
Tunica  Abdominalis,  387 
Turcica  Sella,  154 

Ulna,  203 

Unciforme,  210 

Unguiform  Bone,  164 

Unguis  Os,  164 

Upper  Extremities,  Articulations  of,  286 
Bones  of,  197 
Development  of,  215 
Mechanism  of,  216 
Muscles  of,  410 
Jaw,  159 

Urea,  58 

Use  of  Sutures,  175 

Uvula,  490 


510 


INDEX  TO  VOL.  I. 


Vastus  Externus,  438 
Interims,  438 
Vault  of  Cranium,  178 
Veins  of  Bones,  89 

Diploe,  170 
Velpeau  on  Bones,  83 
Ventrier,  388 
Vertebrae,  108 

Caudal,  117 

Cervical,  109 

Dorsal,  112 

Development  of,  118 

Lumbar,  114 

Pelvic,  115 

Uses  and  Motions  of,  118 


Vertebral  Ligaments,  271 
Vincula  Accessoria,  422 
Vomer,  165 

White  Fibrous  Tissue,  259 
Winslow,  Ligament  of,  304 
Wormiana  Ossa,  174 
Wrist,  Articulations  of,  293 

Xyphoid  Cartilage,  136 
Yellow  Fibrous  Tissue,  261 

Zygomaticus  Major,  373 
Minor,  373 


END   OP  VOL.    I. 


CATALOGUE 


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1  vol.  Svo.,  448  pages,  manv  cuts. 
|  Youatt  and  Clater's  Cattle  Doctor,  1  vol.  12mo., 

282  pages,  cuts. 
Youatt  on  the  Dog,  by  Lewis,  1  vol.  demy  Svo., 

403  panes,  beautiful  plates. 

i  Yoiiiitl  on  the  Pig,  A  new  work,  with  beautiful  il- 
|  lustrations  of  all  the  different  varieties,  12mo. 
works  uie  in  preparation. 


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CONTENTS  OF  THE 

AMERICAN  JOURNAL  OF  THE  MEDICAL  SCIENCES,    April,  1851. 
ORIGINAL    COMMUNICATIONS. 

MKMOIRS  AND  CASKS     pp.  '4-5-391. 

Art.  I.  Warren's  Account  of  two  Indian  Dwarfs  exhibited  under  the  name  of  Aztec  Children.  (With  two 
plates)  H.  VVatson's  Cases  of  Gunshot  Wound  in  Left  Axilla— Ligature  of  [/eft  Subclavian,  and  sub^e- 
quent  Ligatures  of  Brachial  and  Siibscapulat  Arteries.  III.  Bacon's  Observations  on  the  Durnb-Bell  Urina- 
ry Deposit.  IV.  Parsons  on  some  of  the  Remote  K  (!"••(.•  is  of  Injuries  of  Nerves.  V.  Morland's  Extracts  from 
the  Records  of  the  Boston  Society  for  Medical  Improvement.  VI.  Johnston's  Remarkable  Obstetrical  Cases. 
(With  a  wood  cut.)  VII.  Jackson  on  Hot  Water  in  Sprains  VIIF.  Kneeland's  Report  on  Idiotic  Crania,  Idio- 
cy, and  Cretinism.  IX  Adams'  Case  of  Haemoptysis  Neonatorum.  X.  Dnlto.ii  on  a  new  form  of  Phosphate 
of  Lime  in  Crystals;  as  it  occurs  in  Putrefying  Urine.  (With  seven  wood-cuts)  XI.  Peaslee's  Ca.*e  of 
Double  Ovarian  Dropsy— both  Ovaries  successfully  removed  by  the  large  Peritoneal  Section.  XII. 
Mcllvaine's  Cases  in  Surgical  Practice. 

REVIEWS,     pp.  391-417. 

XTII.  Report  of  the  Sanitary  Commission  of  Massachusetts.    XIV.  Muse"e  d'Anatomie  de  la  Facult4  de 
M6decine  de  Strasbourg— Histoire  des  Polypes  du  Larynx.    Par  C.  H.  Ehrmann. 
BIBLIOGRAPHICAL  NOTICES,    pp.  417-450. 

XV.  Beck's  Elements  of  Medical  Jurisprudence.  Taylor's  Medical  Jurisprudence.  XVI.  Sutton's  His- 
tory of  Typhoid  Fever,  XVII.  Ricord's  illustrations  of  Syphilitic  Disease.  XVIII.  Nunnely  on  Anaesthe- 
sia and  Anaesthetic  Substances  generally.  XIX.  Fosgale  on  Sleep  Psychologically  considered  with  reference 
to  Sensation  and  Memory.  XX.  Webster's  Notes  on  a  Recent  Visit  to  several  Provincial  Asylums  for  the 
Insane  in  France.  XXI.  Bond's  Practical  Treatise  on  Dental  Medicine.  XXII.  Warren's  Address  before 
the  American  Medical  Association,  in  Cincinnati.  May  8ih,  1S50.  XXIH.  Dunglison  on  New  Remedies, 
with  Formulas  for  their  Administration.  XXIV.  Tilt  on  Diseases  of  Menstruation.  XXV.  Billing's  First 
Principles  of  Medicine.  Second  American  edition.  XXVI.  Murphy's  Review  of  Chemistry  for  Students. 
XXVII.  The  Uses  and  Abuses  of  Air.  XXVIII.  Yeoman  on  Consumption  of  the  Lungs.  XXIX.  An  Ap- 
peal to  the  public  in  behalf  of  a  Hospital  for  Sick  Children. 

QUARTERLY  SUMMARY. 

FOREIGN    INTELLIGENCE. 

ANATOMY  AND  PHYSIOLOGY,    pp.  451-457. 

1.  Peacock  on  the  Weight  of  the  Brain  at  different  periods  of  life.  2.  Coulson  on  the  Anatomy  of  the  Sub- 
cutaneous Bursre  3.  Rainey  on  the  Round  Ligament  of  the  Uterus.  4.  Hancock  on  New  Muscles  of  the 
Urethra.  5  Robertson  on  Fistula  of  Stomach.  0.  Toynbee's  Researches  to  prove  the  Nonvascularity  of 
certain  Animal  Tissues.  7.  Bernard  on  the  Absorption  of  Alimentary  Substances,  and  the  Functions  of  the 
Lac  teals. 

MATERTA  MEDTCA  AND  PHARMACY,    pp.  458-462. 

8.  Bagot  on  Evil  Effects  following  the  Incautious  Administration  of  Chloroform.  9.  Flourens  on  the 
Effects  of  Chlorinated  Hydrochloric  Ether  on  Animals.  10.  Snow  on  the  Inhalation  of  various  Medicinal 
Substances.  11.  Rovth  on  the  Physiological  Effects  of  Piootoxine,  or  the  Active  Principle  of  Cocculus  In- 
dicus.  12.  Dorvault  on  lodognosis.  13.  Routh  on  New  Preparation  of  Phosphate  of  Iron. 

MEDICAL  PATHOLOGY  AND  THERAPEUTICS  AND  PRACTICAL  MEDICINE,  pp.  4G2-491. 

14.  Ancell  on  Tubercle  and  Tuberculosis.  15.  Van  >1er  Kolk  on  Elastic  Fibres  in  the  Sputa  of  Phthisis. 
16.  Redfern  on  Fibre  in  the  Structure  of  Cancer.  17.  Johnsonon  Chemical  and  Microscopical  Examination 
of  the  Urine  in  Renal  Diseases.  18.  Johnson's  Cases  of  Renal  Disease.  19.  Johnson's  Diagnosis  of  Fatty 
Degeneraiion  of  Kidney.  20.  Namias  on  Atrophy  of  the  Spinal  Marrow.  21  Knox  on  Vaccination  as  a 
Preventive  of  Small- pox.  22.  Craninxon  Vaccination  and  Revaccination.  23.  Results  of  Revaccination 
in  the  Prussian  Army  during  1849.  24.  Aran  on  Abortive  Treatment  of  Variola  with  Collodion.  25.  Roger 
on  Combination  of  Auscultation  and  Percass'on.  26.  Trousseau  and  Lastgue  on  Auscultation  in  the  Pneu- 
monia of  Infants.  27.  Simpson  on  Local  Paralysis  in  Infancy.  2S.  Helfft  on  Recent  Epidemic  of  Scarlatina 
at  Berlin.  29.  Boudin  on  Cretinism..  30.  Causes  and  Cure  of  Goitre  31.  Aran  on  Chloroform  in  Lead- 
Colic.  32.  Bazin  and  Bourguignon  on  the  Treatment  of  Itch.  33.  Troussf.au  on  Disease  of  the  Heart  and 
Chorea.  34.  SulpJiate  of  Zinc  in  Chorea.  35.  Chambers  on  the  Treatment  of  Obesity. 

SURGICAL  PATHOLOGY  AND  THERAPEUTICS  AND  OPERATIVE  SURGERY,    pp.  491-516. 

36.  Hewetts  Case  illustrating  the  Difficulties  of  Diagnosis  of  Morbid  Growths  from  the  Upper  Jaw.  37. 
Skey  on  the  Results  of  the  use  of  Chloroform,  in  9UOO  cases  at  St.  Bartholomew's  Hospital.  38.  Coulson  on 
the  Pathology  and  Treatment  of  enlarged  Subcutaneous  Bursae.  39  Lloyd's  Treatment  of  certain  cases  of 
Hare-lip.  40  Walton  on  Excision  of  the  Head  of  the  Femur.  41.  Norman's  Case  of  Ovariotomy ;  Sponta- 
neous Disappearance  of  Ovarian  Tumours.  42-  Taylor's  Case  of  Tumour  for  which  the  Operation  of  Ovari- 
otomy was  attempted  more  than  twenty-five  years  ago,  with  Dissection.  43.  Smyly  on  Femoral  Aneurism 
cured  by  Compression.  44.  Waklvy>s  New  Instruments  for  the  Cure  of  Stricture.  45.  Stark  on  Rupture  of 
the  Crucial  Ligament  of  the  Knee-joint.  46.  Cotton  Wadding  as  an  Application  to  Bed-Sores  and  Varicose 
Ulcers. 

OPHTHALMOLOGY,   pp.  516-519. 

47.  Jacob  on  Preparatory  and  After-treatment  in  Cataract  Operations. 

MIDWIFERY,    pp.  519-524. 

48.  Gray's  Case  of  Protrusion  of  the  Hand  of  the  Child  through  the  Walls,  of  the  Vagina  and  Rectum  in  a 
case  of  Head  Presentation.    49.  Thatcher  on  Central  Laceration  of  the  Perineum.    50.   West's  Case  of  Caesa- 
rian Section,  with  Remarks  on  the  Danger  of  the  Operation.    51.  Oldham's  Case  of  Caesarian  Section.    52. 
Lee  on  the  Caesarian  Section  and  Premature  Labour.    53,  Lagaeon  Injury  of  the  Cranium  and  Wound  of 
the  Brain  in  a  New-born  Child— Recovery.    54.  Quintuple  Birth.    55.  Farrige  on  Polypous  Excrescences 
from  Umbilicus  in  New-born  Children. 

MEDICAL  JURISPRUDENCE  AND  TOXICOLOGY,    pp.  224-530. 

56.  Identity.  57.  Abortion.  58.  Ancient  Trial  for  Impotence.  59.  Absence  of  Milk  after  Delivery.  60. 
Present  Law  of  Virginia  concerning  Abortion.  61.  Legal  Definition  of  what  constitutes  a  Wound.  62. 
Procuring  Abortion,  or  Premature  Birth.  63.  Poisoning  with  Cocculus  Indicus.  64  Chevalier  on  the  Dis- 
eases of  Manufacturers  of  Sulphate  of  Quinine.  &5.  Pelouse  and  Bernard  on  Curare.  66.  Salisbury's  Case 
of  Abortion  by  Savin. 

AMERICAN    INTELLIGENCE. 

ORIGINAL  COMMUNICATIONS,    pp.  531-534. 

Wills  Hospital— Service  of  Dr.  Isaac  Hays— Cases  discharged  from  Oct.  1st,  1850,  to  Jan.  1, 1851.    By  A. 
F.  Macintyre,  M.  D.    GardeUe  on  Lectureship  on  Dental  Surgery  in  Medical  Colleges. 
DOMESTIC  SUMMARY,  pp  535-544. 

Church  on  Femoral  Aneurism  cured  by  Compression.  Lente  on  Coup  de  Soleil,  or  Sun  Stroke.  Jeter's 
Case  of  Caesarian  Section.  Campbell  on  Striped  and  Unstriped  Muscular  Fibre.  Cookers  Antilithic  Paste. 
Wright  on  the  Vapour  of  Water  in  an  Overdose  of  Opium.  Refracture  of  a  Leg  to  Improve  Defective  Sur- 
gery. Ready  on  Aphonia  and  Obstinate  Cough  from  .Prolongation  of  the  Uvula.  Lindsly's  two  Cases  ot 
Mumps,  with  Metastasis  to  the  Brain,  both  terminating  fatally.  Dugas  on  Dislocation  of  the  Radius  and 
Ulna  backwards  at  the  Elbow.  An  Act  to  Promote  Medical  Inquiry  and  Instruction.  By  Mr.  Tulhill. 
American  Medical  Association. 


6  BLANCHARD  &  LEA'S  PUBLICATIONS.—  (Surgery.) 

GROSS  ON  URINARY  ORGANS— (Now  Ready.) 
A  PEACTICAL  TREATISE  ON  THE 

DISEASES  AND  INJURIES  GF  THE  URINARY  ORGANS. 

BY  S.  D.  GROSS,  M  D.,  &c., 

Professor  of  Surgery  in  the  New  York  University. 

In  one  large  and  beautifully  printed  octavo  volume,  of  over  seven  hundred  pages. 
With  numerous  Illustrations. 

The  author  of  this  work  has  devoted  several  years  to  its  preparation,  and  has  endeavored  to 
render  it  complete  and  thorough  on  all  points  connected  with  the  important  subject  to  which  it  is 
devoted.  It  contains  a  large  number  of  original  illustrations,  presenting  the  natural  and  patholo- 
gical anatomy  of  the  parts  under  consideration,  instruments,  modes  of  operation,  &c.  &c.,  and  in 
mechanical  execution  it  is  one  of  the  handsomest  volumes  yet  issued  from  the  American  press. 

A  very  condensed  summary  of  the  contents  is  subjoined. 
INTRODUCTION.— CHAPTER!,  Anatomy  of  the  Perinaeum.— CHAP.  II,  Anatomy  of  the  Urinary  Bladder.— 

CHAP.  III.  Anatomy  of  the  Prostate.— CHAP.  IV,  Anatomy  of  the  Urethra. — CHAP.  V,  Urine. 
PART.  I,  DISEASES  AND  INJURIKS  OF  THE  BLADDER. 

CHAP.  I.  Malformations  and  Imperfections.— CHAP.  II.  Injuries' of  the  Bladder.— CHAP.  Ill,  Inflammation 
of  the  Bladder.— CHAP.  IV,  Chronic  Lesionsof  the  Bladder.— CHAP  V,  Nervous  Affections  of  the  Bladder. 
— CHAP.  VI.  Heterologous  Formations  of  the  Bladder.-  CHAP.  VH.  Polypous,  Fungous,  Erectile,  and 
other  Morbid  Growths  of  the  Bladder.— CHAP.  VIII  Worms  in  the  Bladder —  CHAP.  IX,  Serous  Cysts 
and  Hydatids.— CHAP.  X,  Postal  Remain?  in  the  Bladder.— CHAP.  XI,  Hair  in  the  Bladder.— CHAP.  XII, 
Air  in  the  Bladder.— CHAP.  XIII.  Hemorrhage  of  the  Bladder. — CHAP.  XIV,  Retention  of  Urine.— CHAP. 
XV,  Incontinence  of  Urine.— CHAP.  XVI,  Hernia  of  the  Bladder.— CHAP.  XVII,  Urinary  Deposits. — 
CHAP.  XVHI,  Stone  in  the  Bladder.— CHAP.  XIX.  Foreign  Bodies  in  the  Bladder. 
PART  II,  DISEASES  AND  INJURIES  OF  THE  PROSTATE  GLAND. 

CHAP.  I,  Wounds  of  the  Prostate.— CHAP.  II,  Acute  Prostatis.— CHAP.  Ill,  Hypertrophy  of  the  Prostate. — 
CHAP.  IV,  Atrophy  of  the  Prostate.— CHAP.  V,  Heterologous  Formations  of  the  Prostate.— CHAP.  VI,  Cys- 
tic Disease  of  the  Prostate. — CHAP.  VII,  Fibrous  Tumors  of  the  Prostate — CHAP.  VIII,  Hemorrhage  of 
the  Prostate.— CHAP.  IX.  Calculi  of  the  Prostate.— CHAP.  X,  Phlebitis  of  the  Prostate. 
PART  III,  DISEASES  AND  INJURIES  OF  THE  URETHRA. 

CHAP.  I,  Malformations  and  Imperfections  of  the  Urethra.— CHAP.  II,  Laceration  of  the  Urethra.—  CHAP. 
Ill,  Stricture  of  the  Urethra. — CHAP.  IV,  Polypoid  and  Vascular  Tumors  of  the  Urethra. — CHAP.  V.  Neu- 
ralgia of  the  Urethra. — CHAP.  VI,  Hemorrhage  of  the  Urethra.—  CHAP.  VII.  Foreign  Bodies  in  the  Urethra. 
—CHAP.  VIII,  Infiltration  of  Urine.— CHAP  IX,  Urinary  Abscess.— CHAP.  X,  Fistula  of  the  Urethra.— 
CHAP.  XI,  False  Passages.— CHAP.  XII,  Lesions  of  the  Gallinaginous  Crest. — CHAP.  XIII,  Inflammation 
and  Abscess  of  Cowper's  Glands. 


COOPER  Otf  DISLOCATIONS.— New  Edition  (Now  Ready). 
A  TREATISE  ON 

DISLOCATIONS  AND  FRACTURES  OF  THE  JOINTS. 

BY  SIR  ASTLEY  P.  COOPER,  BART.,  F.  R.  S.,  &c. 

EDITED  BY  BRANSBY  B.  COOPER,  F.  R.  S.,  &c. 

WITH  ADDITIONAL  OBSERVATIONS  BY  PROF.  J.  C.  WARREN. 

A    NEW     AMERICAN     EDITION, 

In  one  handsome  octavo  volume,  with  numerous  illustrations  on  wood. 

After  the  fiat  of  the  profession,  it  would  be  absurd  in  us  to  eulogize  Sir  Astley  Cooper's  work  on  Disloca- 
tions. It  is  a  national  one,  and  will  probably  subsist  as  long  as  English  Surgery. — Medico- Ckirurg.  Review. 

WORKS    BY    THE    SAME    AUTHOR. 

COOPER  (SIR  ASTLEY)  ON  THE  ANATOMY  AND  TREATMENT  OF  ABDOMINAL  HERNIA, 

1  large  vol.,  imp.  8vo.,  with  over  130  lithographic  figures. 
COOPER  ON  THE  STRUCTURE  AND  DISEASES  OF  THE  TESTIS,  AND  ON  THE  THYMUS 

GLAND.  1  vol.,  imp.  8vo.,  with  177  figures  on  29  plates. 
COOPER  ON  THE  ANATOMY  AND  DISEASES  OF  THE  BREAST,  WITH  TWENTY-FIVE 

MISCELLANEOUS  AND  SURGICAL  PAPERS.    1  large  vol.,  imp.  8vo.,  with  252  figures  on  36  plates. 

These  three  volumes  complete  the  surgical  writings  of  Sir  Astley  Cooper.  They  are  very  handsomely 
printed,  with  a  large  number  of  lithographic  plates,  executed  in  the  best  style,  and  are  presented  at  exceed- 
ingly low  prices. 

LXSTON  &  MUTTER'S  SURGERY. 

LECTURES  ON  THE  OPERATIONS  OF  SURGERY, 

AND  ON  DISEASES  AND  ACCIDENTS  REQUIRING  OPERATIONS. 

BY  ROBERT   LISTON,  ESQ.,   F.  R.  S.,  &c. 

EDITED,  WITH  NUMEROUS  ADDITIONS  AND  ALTERATIONS, 

BY  T.  D.  MUTTER,  M.  D., 

Professor  of  Surgery  in  the  Jefferson  Medical  College  of  Philadelphia. 
In  one  large  and  handsome  octavo  volume  of  566  pages,  with  216  wood-cuts. 


BLANCHARD   &  LEA'S  PUBLICATIONS.— (Surgery.) 


LIBRARY    OF    SURGICAL   KNOWLEDGE. 

A  SYSTEM  OF  SURGERY. 

BY   J.    M.    CHELIUS. 

TRANSLATED  FROM  THE  GERMAN, 
AND  ACCOMPANIED  WITH  ADDITIONAL  NOTES  AND  REFERENCES, 

BY  JOHN  F.  SOUTH. 

Complete  in  three  very  large  octavo  volumes  of  nearly  2200  pages,  strongly  bound,  with  raised 
bands  arid  double  titles:  or  in  seventeen  numbers,  at  fifty  cents  each. 

We  do  not  hesitate  to  pronounce  it  the  best  and  most  comprehensive  system  of  modern  surgery  with 
which  we  are  acquainted. —  Medico- Chirurgical  Review. 

The  fullest  and  ablest  digest  extant  of  all  that  relates  to  the  present  advanced  state  of  Surgical  Pathology.  - 
American  Medical  Journal. 

If  we  were  confined  to  a  single  work  on  Surgery,  that  work  should  he  Chelius's.—  St.  Louis  Med.  Journal. 

As  complete  as  any  system  of  Surgery  can  well  be. — Southern  Medical  and  Surgical  Journal. 

The  most  finished  system  of  Surgery  in  the  English  language. —  Western  Lancet. 

The  most  learned  and  complete  systematic  treatise  now  extant. — Edinburgh  Medical  Journal. 

No  work  iu  the  English  language  comprises  so  large  an  amount  of  information  relative  to  operative  medi- 
cine and  surgical  pathology. — Medical  Gazette. 

A  complete  encyclopedia  of  surgical  science— a  very  complete  surgical  library— by  far  the  most  complete 
and  scientific  system  of  surgery  in  the  English  language.— JV.  Y.  Journal  of  Medicine. 

One  of  the  most  complete  treatises  on  Surgery  in  the  English  language  —Monthly  Journal  of  Med.  Science. 

The  most  extensive  arid  comprehensive  account  of  the  art  and  science  of  Surgery  in  our  language. — Lancet. 


A  TREATISE  ON  THE  DISEASES  OF  THE  EYE, 

BY  W.  LAWRENCE,  F.R.S. 

A  new  Edition.     With  many  Modifications  and  Additions,  and  the  introduction  of  nearly  200  Illustrations, 

BY  ISAAC  HAYS,  M.D. 
In  one  very  large  8vo.  vol.  of  860  pages,  with  plates  and  wood-cuts  through  the  text. 

JONES   ON  THE  EYE. 

THE  PRINCIPLES~AND  PRACTICE 

OF  OPHTHALMIC  MEDICINE  AND  SURGERY, 

BY  T.  WHARTON  JONES,  F.  R.  S.,  &c.  &c. 

EDITED  BY  ISAAC  HAYS,  M.  D.,  &c. 

In  one  very  neat  volume,  large  royal  12mo.  of  529  pages,  with  four  plates,  plain  or  colored,  and 
ninety-eight  well  executed  wood-cuts. 


MILLER'S  PRINCIPLES  AND  PRACTICE  OF  SURGERY. 

THE    PRINCIPLES   OF   SURGERY. 

Second  edition,  one  vol.  Svo. 

THE  PRACTICE  OF  SURGERY. 

Second  edition,  one  vol.  Svo. 

BY  JAMES  MILLER,  F.  R.  S.  E., 

Professor  of  Surgery  in  the  University  of  Edinburgh,  &c. 

STANLEY  ON  THE  BONES.— A  Treatise  on  Diseases  of  the  Bones.    In  one  vol.  8vo.,  extra  cloth.   286  pp 

BRODIE'S  SURGICAL  LECTURES.— Clinical  Lectures  on  Surgery.    1  vol.  8vo.,  cloth.    350  pp. 

BROD1E  ON  THE  JOINTS.— Pathological  and  Surgical  Observations  on  the  Diseases  of  the  Joints.    1  vol. 
8vo.,  cloth.    216pp. 

BRODIE  ON  URINARY  ORGANS.— Lectures  on  the  Diseases  of  the  Urinary  Organs.    1  vol.  8vo.,  cloth. 
214  pp. 

%*  These  three  works  may  be  had  neatly  bound  together,  forming  a  large  volume  of"  Brodie's 
Surgical  Works."    7SOpp. 

RICORD  ON  VENEREAL.— A  Practical  Treatise  on  Venereal  Diseases?  With  a  Therapeutical  Summary 
and  Special  Formulary.    Translated  by  Sidney  Doane,  M  D.     Fourth  edition.    1  vol.  &vo.    340  pp. 

DURLACHER  ON  CORNS,  BUNIONS.  &c.— A  Treatise  on  Corns,  Bunions,  the  Diseases  of  Nails,  and 
the  General  Managementof  the  Feet     In  one  12mo.  volume,  cloth.    134  pp. 

GUTHRIE  ON  THE  BLADDER,  &c.— The  Anatomy  of  the  Bladder  and  Urethra,  and  the  Treatment  of  the 
Obstructions  to  which  those  Passages  are  liable.    In  one  vol.  Svo.     150  pp. 

LAWRENCE  ON  RUPTURES.— A  Treatise  on  Ruptures,  from  the  fifth  London  Edition.    In  one  Svo.  vol. 
sheep.    480  pp. 

MAURY'S  DENTAL  SURGERY.— A  Treatise  on  the  Deiital  Art,  founded  on  Actual  Experience.    Illus- 
trated by  241  lithographic  figures  and  54  wood-cuts.  Translated  by  J.B.  Savier.  In  18vo.  vol.,  sheep    286  pp 

DUFTON  ON  THE  EAR.— The  Nature  undTreaimentof  Deafness  and  Diseasesof  the  Ear;  andthe Treat- 
ment of  the  Deaf  and  Dumb.    One  small  12mo.  volume.    120pp. 

MALGAIGNE'S  SURGERY.— Operative  Surgery,  translated,  with  Notes,  by  Brittan.    With  wood-cuts. 
(Now  publishing  in  the  "•  Medical  News  and  Library.") 

SMITH  ON  FRACTURES.— A  Treatise  on  Fractures  in  the  vicinity  of  Joints,  and  on  Dislocations.    One 
vol.  8vo.,  with  20U  beautiful  wood-cuts. 


BLANCHARD    &   LEA'S    PUBLICATIONS.— (Surgery.) 


NEW  AND  IMPORTANT  WORK  ON  PRACTICAL  SURGERY,-(NOW  READY,) 

OPERATIVE    STTRGEBY. 

BY  FREDERICK  C.  SKEY,  F.  R.  S.,  &c. 

In  one  very  handsome  octavo  volume  of  over  650  pages,  with  about  one  hundred  wood-cuts. 

The  object  of  the  author,  in  the  preparation  of  this  work,  has  been  not  merely  to  furnish  the 
student  with  a  guide  to  the  actual  processes  of  operation,  embracing  the  practical  rules  required 
to  justify  an  appeal  to  the  knife,  but  also  to  present  a  manual  embodying  such  principles  as  might 
render  it  a  permanent  work  of  reference  to  the  practitioner  of  operative  surgery,  who  seeks  to 
uphold  the  character  of  his  profession  as  a  science  as  well  as  an  art.  In  its  composition  he  has 
relied  mainly  on  his  own  experience,  acquired  during  many  years'  service  at  one  of  the  largest  of 
the  London  hospitals,  and  has  rarely  appealed  to  other  authorities,  except  so  far  as  personal  iutei- 
course  and  a  general  acquaintance  with  the  most  eminent  members  of  the  surgical  profession 
have  induced  him  to  quote  their  opinions. 

From  Professor  C.  B.  G-ibson.  Richmond,  Virginia. 

I  have  examined  the  work  with  some  care,  and  am  delighted  with  it.  The  style  is  admirable,  Ihe  matter 
excellent,  and  much  of  it  original  and  deeply  interesting,  whilst  the  illustrations  are  numerous  and  better 
executed  than  those  of  any  similar  work  I  possess. 

In  conclusion  we  must  express  our  unqualified  praise  of  the  work  as  a  whole.  The  high  moral  tone,  the 
liberal  views,  and  the  sound  information  which  pervades  it  throughout,  reflect  the  highest  credit  upon  the 
talented  author.  \Ve  know  of  no  one  who  has  succeeded,  whilst  supporting  operative  surgery  in  its  proper 
rank,  in  promulgating  at  the  same  time  sounder  and  more  enlightened  views  upon  that  most  important  of 
all  subjects,  the  principle  that  should  guide  us  in  having  recourse  to  the  knife. — Medical  Times. 

The  treatise  is,  indeed,  one  on  operative  surgery,  but  it  is  one  in  which  the  author  throughout  shows  that 
he  is  most  anxious  to  place  operative  surgery  in  iis  just  position.  He  has  acted  as  a  judicious,  but  not 
partial  friend;  and  while  he  shows  throughout  that  he  is  able  and  ready  to  perform  any  operation  which  the 
exigencies  and  casualties  of  the  human  frame  may  require,  he  is  most  cautious  in  specifying  the  circum- 
stances which  in  each  case  indicate  and  contraindicate  operation.  It  is  indeed  gratifying  to  perceive  the 
sound  and  correct  views  which  Mr.  Skey  entertains  on  the  subject  of  operations  in  general,  and  the  gentle- 
manly tone  in  which  he  impresses  on  readers  the  lessons  which  he  is  desirous  to  inculcate.  His  work  is  a 
perfect  model  for  the  operating  surgeon,  who  will  learn  from  it  not  only  when  and  how  to  operate,  but  some 
more  noble  and  exalted  lessons  which  cannot  fail  to  improve  him  as  a  moral  and  social  agent.— Edinburgh 
Medical  and  Surgical  Journal. 

THE    STUDENT^S    TEXT-BOOK. 

THE  PRINCIPLES  AND  PRACTICE  OF  MODERN  SURGERY, 

BY  ROBERT  DBUITT,  Fellow  of  the  Royal  College  of  Surgeons. 
A  New  American,  from  the  last  and  improved  London  Edition, 

EDITED  BY  F.  W.  SARGENT,  M.D.,  Author  of  "Minor  Surgery,"  &c. 

ILLUSTRATED  WITH  ONE  HUNDRED  AND  NINETY-THREE  WOOD  ENGRAVINGS. 

In  one  very  handsomely  printed  octavo  volume  of  576  large  pages. 

From  Professor  Brainard,  of  Chicago,  Illinois. 
I  think  it  the  best  work  of  its  size,  on  that  subject,  in  the  language. 

From  Professor  Rivers,  of  Providence,  Rhode  Island. 

I  have  been  acquainted  with  it  since  its  first  repiiblication  in  this  country,  and  the  universal  praise  it  has 
received  I  think  well  merited. 

From  Professor  May,  of  Washington,  D.  C. 

Permit  me  to  express  my  satisfaction  at  the  repubhcation  in  so  improved  a  form  of  this  most  valuable  work. 
I  believe  it  to  be  one  of  the  very  best  text-books  ever  issued. 

From  Professor  McCoolc,  of  Baltimore. 

I  cannot  withhold  my  approval  of  its  merits,  or  the  expression  that  no  work  is  better  suited  to  the  wants 
of  the  svudent.  I  shall  commend  it  to  my  class,  and  make  it  my  chief  text-book. 


FERGUSSON'S  OPERATIVE  SURGERY.    NEW  EDITION. 

A  SYSTEM   OF   PRACTICAL  SURGERY. 

BY  WILLIAM  FERGUSSON,  F.  R.  S.  E., 

Professor  of  Surgery  in  King's  College,  London.  &c.  &c. 

THIRD   AMERICAN,   FROM  THE  LAST   ENGLISH  EDITION. 

With  274  Illustrations. 

In  one  large  and  beautifully  printed  octavo  volume  of  six  hundred  and  thirty  pages. 
It  is  with  unfeigned  satisfaction  that  we  call  the  attention  of  the  profession  in  this  country  to  this  excellent 
work.    It  richly  deserves  the  reputation  conceded  to  it,  of  being  the  best  practical  Surgery  extant,  at  least  in 
the  English  language.— Medical  Examiner. 

A    NEW     MIIVKDR    SURGERY. 

ON  BANDAGING  AND  OTHER  POINTS  OF  MINOR  SURGERY, 

BY  F.  W.  SARGENT,  M.  D. 

In  one  handsome  royal  12mo.  volume  of  nearly  400  pages,  with  128  wood-cute. 

From  Professor  Gilbert,  Philadelphia. 

Embracing  the  smaller  details  of  surgery,  which  are  illustrated  by  very  accurate  engravings,  the  work 
becomes  one  of  very  great  importance  to  the  practitioner  in  the  performance  of  hia  daily  duties,  since  such 
information  is  rarely  found  in  the  general  works  on  surgery  now  in  use. 


BLANCHARD  &  LEA'S  PUBLICATIONS.— (Surgery.)  9 

THE    GREAT    ATLAS    OF    SURGICAL    ANATOMY. 

(NOW    COMPLETE.) 

SUHGICAL'AN  ATOMY. 

BY  JOSEPH  MACLISE,  SURGEON. 

IN  ONE  VOLUME.  IN  VERY  LARGE  IMPERIAL  QUARTO, 
With  Sixty-eight  large  and  splendid  Plates,  many  of  them  the  size   of  life, 

DRAWN    IN    THE    BEST    STYLE    AND    BEAUTIFULLY    COLORED. 
TOGETHER    WITH    OVER   ONE    HUNDRED    AND    FIFTY    LARGE    DOUBLE-COLUMNED   PAGES. 

Strongly  and  handsomely  bound,  being  one  of  the  best  executed  and  cheapest  surgical  works  ever 

presented  in  this  country. 

ALSO,  TO   BE   HAD   IN    PARTS, 
Paris  I.  to  IV.,  price  Two  Hollars  each— Part  \.,  One  Dollar. 

This  great  work  being  now  complete,  the  publishers  confidently  present  it  to  the  attention  of  the 
profession  as  worthy  in  every  respect  of  their  approbation  and  patronage.  No  complete  work 
of  the  kind  has  yet  been  published  in  the  English  language,  and  it  therefore  will  supply  a  want 
long  felt  in  this  country  of  an  accurate  and  comprehensive  Atlas  of  Surgical  Anatomy  to  which 
the  student  and  practitioner  can  at  all  times  refer,  to  ascertain  the  exact  relative  position  of 
the  various  portions  of  the  human  frame  towards  each  other  and  to  the  surface,  as  well  as  their 
abnormal  deviations.  The  importance  of  such  a  work  to  the  student  in  the  absence  of  anato- 
mical material,  and  to  the  practitioner  when  about  attempting  an  operation,  is  evident,  while  the 
price  of  the  book,  notwithstanding  the  large  size,  beauty,  and  finish  of  the  very  numerous  illustra- 
tions is  so  low  as  to  place  it  within  the  reach  of  every  member  of  the  profession.  The  publishers 
therefore  confidently  anticipate  a  very  extended  circulation  for  this  magnificent  work. 

To  present  some  idea  of  the  scope  of  the  volume,  and  of  the  manner  in  which  its  plan  has  been 
carried  out,  the  publishers  subjoin  a  very  brief  summary  of  the  plates. 

Plates  1  and  2. — Form  of  the  Thoracic  Cavity  and  Position  of  the  Lungs,  Heart,  and  larger  Blood- 
vessels. 

Plates  3  and  4. — Surgical  Form  of  the  Superficial  Cervical  and  Facial  Regions,  and  the  Relative 
Positions  of  the  principal  Blood-vessels,  Nerves,  &c. 

Plates  5  and  6. — Surgical  Form  of  the  Deep  Cervical  and  Facial  Regions,  and  Relative  Positions 
of  the  principal  Blood-vessels,  Nerves,  &c. 

Plates  7  and  8. — Surgical  Dissection  of  the  Subclavian  and  Carotid  Regions,  and  Relative  Anatomy 
of  their  Contents. 

Plates  9  and  10. — Surgical  Dissection  of  the  Sterno-Clavicular  or  Tracheal  Region,  and  Relative 
Position  of  its  main  Blood-vessels,  Nerves,  &c. 

Plates  11  and  12. — Surgical  Dissection  of  the  Axillary  and  Brachial  Regions,  displaying  the  Relative 
Order  of  their  contained  parts. 

Plates  13   and!4. — Surgical  Form  of  the  Male  and  Female  Axillae  compared. 

Plates  15  and  16. — Surgical  Dissection  of  the  Bend  of  the  Elbow  and  the  Forearm,  showing  the 
Relative  Position  of  the  Arteries,  Veins,  Nerves,  &c. 

Plates  17,  18  and  19. — Surgical  Dissections  of  the  Wrist  and  Hand. 

Plates  20  and  21. — Relative  Position  of  the  Cranial,  Nasal,  Oral,  and  Pharyngeal  Cavities,  &c. 

Plate  22. — Relative  Position  of  the  Superficial  Organs  of  the  Thorax  and  Abdomen. 

Plate  23. — Relative  Position  of  the  Deeper  Organs  of  the  Thorax  and  those  of  the  Abdomen. 

Plate  24.— Relations  of  the  Principal  Blood-vessels  to  the  Viscera  of  the  Thoracico-Abdominal 
Cavity. 

Plate  25. — Relations  of  the  Principal  Blood-vessels  of  the  Thorax  and  Abdomen  to  the  Osseous 
Skeleton,  &c. 

Plate  26.— Relation  of  the  Internal  Parts  to  the  External  Surface  of  the  Body. 

Plate  27. — Surgical  Dissection  of  the  Principal  Blood-vessels,  &c.,  of  the  Inguino-Femoral  Region. 

Plates  28  and  29. — Surgical  Dissection  of  the  First,  Second,  Third,  and  Fourth  Layers  of  the 
Inguinal  Region,  in  connection  with  those  of  the  Thigh. 

Plates  30  and  31. — The  Surgical  Dissection  of  the  Fifth,  Sixth,  Seventh  and  Eighth  Layers  of  the 
Inguinal  Region,  and  their  connection  with  those  of  the  Thigh. 

Plates  32,  33  and  34.— The  Dissection  of  the  Oblique  or  External  and  the  Director  Internal  Ingui- 
nal Hernia. 

Plates  35,  36,  37  and  38. — The  Distinctive  Diagnosis  between  External  and  Internal  Inguinal  Hernia, 
the  Taxis,  the  Seat  of  Stricture,  and  the  Operation. 

Plates  39  and  40. — Demonstrations  of  the  Nature  of  Congenital  and  Infantile  Inguinal  Hernia,  and 
of  Hydrocele. 

Plates  41  and  42. — Demonstrations  of  the  Origin  and  Progress  of  Inguinal  Hernia  in  general. 

Plates  43  and  44. — The  Dissection  of  Femoral  Hernia,  and  the  Seat  of  Stricture. 

Plates  45  and  46. — Demonstrations  of  the  Origin  and  Progress  of  Femoral  Hernia,  its  Diagnosis,  the 
Taxis,  and  the  Operation. 

Plate  47. — The  Surgical  Dissection  of  the  principal  Blood-vessels  and  Nerves  of  the  Iliac  and  Fe- 
moral Regions. 

Plates  48  and  49.— The  Relative  Anatomy  of  the  Male  Pelvic  Organs. 

Plates  50  and  51. — The  Surgical  Dissection  of  the  Superficial  Structures  of  the  Male  Perineum. 

Plates  52  and  53. — The  Surgical  Dissection  of  the  Deep  Structures  of  the  Male  Perineum. — The 
Lateral  Operation  of  Lithotomy. 


10  BLANCHARD  &  LEA'S  PUBLICATIONS.— (Surgery.) 

MACLISE'S  SURGICAL  ANATOMY— (Continued.) 

Plates  54,  55  and  56. — The  Surgical  Dissection  of  the  Male  Bladder  and  Urethra. — Lateral  and 
Bilateral  Lithotomy  compared. 

Plates  57  and  58. — Congenital  and  Pathological  Deformities  of  the  Prepuce  and  Urethra. — Struc- 
ture and  Mechanical  Obstructions  of  the  Urethra. 

Plates  59  and  60. — The  various  forms  and  positions  of  Strictures  and  other  Obstructions  of  the 
Urethra. — False  Passages. — Enlargements  and  Deformities  of  the  Prostate. 

Plates  61  and  62. — Deformities  of  the  Prostate. — Deformities  and  Obstructions  of  the  Prostatic 
Urethra. 

Plates  63  and  64. — Deformities  of  the  Urinary  Bladder. — The  Operations  of  Sounding  for  Stone,  of 
Catheterism,  and  of  Puncturing  the  Bladder  above  the  Pubes. 

Plates  65  and  66. — The  Surgical  Dissection  of  the  Popliteal  Space,  and  the  Posterior  Crural  Region. 

Plates  67  and  68. — The  Surgical  Dissection  of  the  Anterior  Crural  Region,  the  Ankles,  and  the  Foot. 

Notwithstanding  the  short  time  in  which  this  work  has  been  before  the  profes- 
sion, it  has  received  the  unanimous  approbation  of  all  who  have  examined  it.  From 
among  a  very  large  number  of  commendatory  notices  with  which  they  have  been 
favored,  the  publishers  select  the  following : — 

From  Prof.  Kimball,  Pittsfield,  Mass. 

I  have  examined  these  numbers  with  the  greatest  satisfaction,  and  feel  bound  to  say  that  they  are  alto- 
gether, the  most  perfect  and  satisfactory  plates  of  the  kind  that  I  have  ever  seen. 

From  Prof.  Brainard,  Chicago,  III. 

The  work  is  extremely  well  adapted  to  the  use  both  of  students  and  practitioner!*,  being  sufficiently  exten- 
sive for  practical  purposes,  without  being  so  expensive  as  to  place  it  beyond  their  reach.  Such  a  work  was 
a  desideratum  in  this  country,  and  I  shall  not  fail  to  recommend  it  to  those  within  the  sphere  of  my  acquaint- 
ance. 

From  Prof.  P.  F.  Eve,  Augusta,  Ga. 

I  consider  this  work  a  great  acquisition  to  my  library,  and  shall  take  pleasure  in  recommending  it  on  all 
suitable  occasions. 

From  Prof.  Peaslee,  Brunswick,  Me. 

The  second  part  more  than  fulfils  the  promise  held  out  by  the  first,  so  far  as  the  beauty  of  the  illustrations 
is  concerned  ;  and,  perfecting  my  opinion  of  the  value  of  the  work,  so  far  as  it  has  advanced,  I  need  add 
nothing  to  what  I  have  previously  expressed  to  you. 

From  Prof.  Gunn,  Ann  Arbor,  Mich. 

The  plates  in  your  edition  of  Mac  Use  answer,  in  an  eminent  degree,  the  purpose  for  which  they  are 
intended.  I  shall  take  pleasure  in  exhibiting  it  and  recommending  it  to  my  class. 

From  Prof.  Rivers,  Providence,  R.  I. 
The  plates  illustrative  of  Hernia  are  the  most  satisfactory  I  have  ever  met  with. 

From  Professor  S.  D.  Gross,  Louisville,  Ky. 

The  work,  as  far  as  it  has  progressed, is  most  admirable,  and  cannot  fail,  when  completed,  to  form  a  most 
valuable  contribution  to  the  literature  of  our  profession.  It  will  afford  me  great  pleasure  to  recommend  it  to 
the  pupils  of  the  University  of  Louisville. 

From  Professor  R.  L.  Howard,  Columbus,  Ohio. 

In  all  respects,  the  first  number  is  the  beginning  of  a  most  excellent  work,  filling  completely  what  might   « 
be  considered  hitherto  a  vacuum  in  surgical  literature.     For  myself,  in  behalf  of  the  medical  profession.  I 
wish  to  express  to  you  my  thanks  for  this  truly  elegant  and  meritorious  work.    I  am  confident  that  it  will 
meet  with  a  ready  and  extensive  sale.    I  have  spoken  of  it  in  the  highest  terms  to  my  class  and  my  profes- 
sional brethren. 

From  Prof.  C.  B.  Gibson,  Richmond,  Va. 

I  consider  Maclise  very  far  superior,  as  to  the  drawings,  to  any  work  on  Surgical  Anatomy  with  which  I 
am  familiar,  and  [  am  particularly  struck  with  the  exceedingly  low  price  at  which  it  is  sold.  I  cannot  doubt 
that  it  will  be  extensively  purchased  by  the  profession. 

From  Prof.  Granville  S.  Pattison,  New  York. 

The  profession,  in  my  opinion,  owe  you  many  thanks  for  the  publication  of  this  beautiful  work — a  work 
which,  in  the  correctness  of  its  exhibitions  of  Surgical  Anatomy,  is  not  surpassed  by  any  work  with  which 
I  am  acquainted;  and  the  admirable  manner  in  which  the  lithographic  plates  have  been  executed  and 
colored  is  alike  honorable  to  your  house  and  to  the  arts  in  the  United  States. 

From  Prof.  J.  F.  May,  Washington,  D.  C. 

Having  examined  the  work,  I  am  pleased  to  add  my  testimony  to  its  correctness,  and  to  its  value  as  a 
work  of  reference  by  the  surgeon. 

From  Prof.  Alden  Marsh,  Albany,  N.  Y. 

From  what  I  have  seen  of  it,  I  think  the  design  and  execution  of  the  work  admirable,  and,  at  the  proper 
time  in  my  course  of  lectures,  I  shall  exhibit  it  to  the  class,  and  give  it  a  recommendation  worthy  of  its  great 
merit. 

From  H.  H.  Smith,  M.  D.,  Philadelphia. 

Permit  me  to  express  my  gratification  at  the  execution  of  Maclise's  Surgical  Anatomy.  The  plates  are,  in 
my  opinion,  the  best  lithographs  that  I  have  seen  of  a  medical  character,  and  the  coloring  of  this  number 
cannot,  I  think,  be  improved.  Estimating  highly  the  contents  of  this  work,  I  shall  continue  to  recommend  it 
to  my  class  as  I  have  heretofore  done. 

From  Prof.  D.  Gilbert,  Philadelphia. 

Allow  me  to  say,  gentlemen,  that  the  thanks  of  the  profession  at  large,  in  this  country,  are  due  to  you  for 
the  republication  of  this  admirable  work  of  Maclise.  The  precise  relationship  of  the  organs  in  the  regions 
displayed  is  so  perfect,  that  even  those  who  have  daily  access  to  the  dissecting-room  may,  by  consulting 
this  work,  enliven  and  confirm  their  anatomical  knowledge  prior  to  an  operation.  But  it  is  to  the  thousands 
of  practitioners  of  our  country  who  cannot  enjoy  these  advantages  that  the  perusal  of  those  plates,  with 
their  concise  and  accurate  descriptions,  will  prove  of  infinite  value.  These  have  supplied  a  desideratum, 
which  will  enable  them  to  refresh  their  knowledge  of  the  important  structures  involved  in  their  surgical 
cases,  thus  establishing  their  self  confidence,  and  enabling  them  to  undertake,  operative  procedures  with 
every  assurance  of  success.  And  as  all  the  practical  departments  in  medicine  rest  upon  the  same  basis,  and 
are  enriched  from  the  same  sources,  I  need  hardly  add  that  this  work  should  be  found  in  the  library  of  every 
practitioner  in  the  land. 


BLANCHARD  &  LEA'S   PUBLICATIONS.— (Surgery.)  ]1 

MACLISE'S   SURGICAL^NATOMY— (Continued.) 

From  Professor  J.  M.  Bush,  Lexington,  Ky. 

I  am  delighted  with  both  the  plan  and  execution  of  the  work,  and  shall  take  all  occasions  to  recommend  it 
to  my  private  pupils  and  public  classes. 

The  most  accurately  engraved  and  beautifully  colored  plates  we  have  ever  seen  in  an  American  book- 
one  of  the  best  and  cheapest  surgical  works  ever  published.—  Buffalo  Medical  Journal. 

It  is  very  rare  that  so  elegantly  printed,  so  well  illustrated,  and  so  useful  a  work,  is  offered  at  so  moderate 
a  price. — Charleston  Medical  Journal. 

A  work  which  cannot  but  please  the  most  fastidious  lover  of  surgical  science,  and  we  hesitate  not  to  say 
that  if  the  remaining  three  numbers  of  this  work  are  in  keeping  with  the  present,  it  cannot  fail  to  give  uni- 
versal satisfaction.  In  it,  by  a  succession  of  plates,  are  brought  to  view  the  relative  anatomy  of  the  parts 
included  in  the  important  surgical  divisions  of  the  human  body,  with  that  fidelity  and  neatness  of  touch  which 
is  scarcely  excelled  by  nature  herself.  The  part  before  us  differs  in  many  respects  from  anything  of  the  kind 
which  we  have  ever  seen  before.  While  we  believe  that  nothing  but  an  extensive  circulation  can  compen- 
sate the  publishers  for  the  outlay  in  the  production  of  this  edition  of  the  work— furnished  as  it  is  at  a  very 
moderate  price,  within  the  reach  of  all— we  desire  to  see  it  have  that  circulation  which  the  zeal  and  peculiar 
skill  of  the  author  (he  being  his  own  draughtsman),  the  utility  of  the  work,  and  the  neat  style  with  which  it 
is  executed  should  demand  for  it  in  a  liberal  profession. — N.  Y.  Journal  of  Medicine. 

This  is  an  admirable  reprint  of  a  deservedly  popular  London  publication.  Its  English  prototype,  although 
not  yet  completed,  has  already  won  its  way,  amongst  our  British  brethren,  to  a  remarkable  success.  Its 
plates  can  boast  a  superiority  that  places  them  almost  beyond  the  reach  of  competition.  And  we  feel  too 
thankful  to  the  Philadelphia  publishers  tor  their  very  handsome  reproduction  of  the  whole  work,  and  at  a 
rate  within  everybody's  reach,  not  to  urge  all  our  medical  friends  to  give  it.  for  their  own  sakes,  the  cordial 
welcome  it  deserves,  in  a  speedy  and  extensive  circulation.—  The,  Medical  Examiner. 

The  plates  are  accompanied  by  references  and  explanations,  and  when  the  whole  has  been  published  it 
will  be  a  complete  and  beautiful  system  of  Surgical  Anatomy,  having  an  advantage  which  is  important,  and 
not  possessed  by  colored  plates  generally,  viz..  its  cheapness,  which  places  it  within  the  reach  of  every  one 
who  may  feel  disposed  to  possess  the  work.  Every  practitioner,  we  think,  should  have  a  work  of  this  kind 
within  reach,  as  there  are  many  operations  requiring  immediaie  performance  in  which  a  book  of  reference 
will  prove  most  valuable. — Southern  Medical  and  Surg.  Journal. 

The  work  of  Maclise  on  Surgical  Anatomy  is  of  the  highest  value.  In  some  respects  it  is  the  best  pub- 
lication of  its  kind  we  have  seen,  and  is  worthy  of  a  place  in  the  librarv  of  any  medical  man,  while  the  stu- 
dent could  scarcely  make  a  better  investment  than  this. —  The  Western  Journal  of  Medicine  and  Surgery. 

No  such  lithographic  illustrations  of  surgical  regions  have  hitherto,  we  think, "been  given  While  the  ope- 
rator is  shown  every  vessel  and  nerve  where  an  operation  is  contemplated,  the  exact  anatomist  is  refreshed 
by  those  clear  and  distinct  dissections  which  every  one  must  appreciate  who  has  a  particle  of  enthusiasm. 
The  English  medical  press  has  quite  exhausted  the  words  of  praise  in  recommending  this  admirable  treatise. 
Those  who  have  any  curiosity  to  gratify  in  reference  to  the  perfectibility  of  the  lithographic  art  in  delinea- 
ting the  complex  mechanism  of  the  human  body,  are  invited  to  examine  our  specimen  copy.  If  anything 
will  induce  surgeons  and  students  to  patronize  a  book  of  such  rare  value  and  every-day  importance  to  them, 
it  will  be  a  survey  of  the  artistical  skill  exhibited  in  these  fac-similes  of  nature. — Boston  Medical  and  Surg. 
Journal. 

The  fidelity  and  accuracy  of  the  plates  reflect  the  highest  credit  upon  the  anatomical  knowledge  of  Mr. 
Maclise.  We  strongly  recommend  the  descriptive  commentaries  to  the  perusal  of  the  student  both  of  sur- 
gery and  medicine.  These  plates  will  form  a  valuable  acquisition  to  practitioners  settled  in  the  country, 
whether  engaged  in  surgical,  medical,  or  general  practice. — Edinburgh.  Medical  and  Surgical  Journal. 

We  are  well  assured  that  there  are  none  of  the  cheaper,  and  but  few  of  the  more  expensive  works  on 
anatomy,  which  will  form  so  complete  a  guide  to  the  student  or  practitioner  as  these  plates.  To  practitioners, 
in  particular,  we  recommend  this  work  as  far  better,  and  not  at  all  more  expensive,  than  the  heterogeneous 
compilations  most  commonly  in  use,  and  which,  whatever  their  value  to  the  student  preparing  for  examina- 
tion, are  as  likely  to  mislead  as  to  guide  the  physician  in  physical  examination,  or  the  surgeon  in  the  per- 
formance of  an  operation. — Monthly  Journal  of  Mtdical  Sciences. 

The  dissections  from  which  these  various  illustrations  are  taken  appear  to  have  been  made  with  remark- 
able success  ;  and  they  are  most  beautifully  represented.  The  surgical  commentary  is  pointed  and  practical. 
We  know  of  no  work  on  surgical  anaiomy  which  can  compete  with  it. — Lancet. 

This  is  by  far  the  ablest  work  on  Surgical  Anatomy  that  has  corne  under  our  observation.  We  know  of 
no  other  work  that  would  justify  a  student,  in  any  degree,  for  neglect  of  actual  dissection.  A  careful  study 
of  these  plates,  and  of  the  commentaries  on  them,  would  almost  make  an  anatomistof  a  diligent  student.  And 
to  one  who  lias  studied  anatomy  by  dissection,  this  work  is  invaluable  as  a  perpetual  remembrancer,  in  mat- 
ters of  knowledge  that  may  slip  from  the  memory.  The  practitioner  can  scarcely  consider  himself  equipped 
for  the  duties  of  his  profession  without  such  a  work  as  this,  and  this  has  no  rival,  in  his  library.  In  those 
sudden  emergencies  that  so  ofien  arise,  and  which  require  the  instantaneous  command  of  minute  anatomical 
knowledge,  a  work  of  this  kind  keeps  the  details  of  the  dissecting-roorn  perpetually  fresh  in  the  memory. 
We  appeal  to  our  readers,  whether  any  one  can  justifiably  undertake  the  practice  of  medicine  who  is  not 
prepared  to  give  all  needful  assistance,  in  all  matters  demanding  immediate  relief. 

We  repeat  that  no  medical  library,  however  large,  can  be  complete  without  Maclise's  Surgical  Anatomy. 
The  American  edition  is  well  entitled  to  the  confidence  of  the  profession,  and  should  command,  among  them, 
an  extensive  sale.  The  invesiment  of  the  amount  of  the  cost  of  this  work  will  prove  to  be  a  very  profitable 
one.  and  if  practitioners  would  qualify  themselves  thoroughly  with  such  important  knowledge  as  id  contained 
in  works  of  this  kind,  there  would  be  fewer  of  them  sighing  for  employment.  The  medical  profession  should 
spring  towards  such  an  opportunity  as  is  presented  in  this  republication,  to  encourage  frequent  repetitions  of 
American  enterprise  of  this  kind.—  The  Western  Journal  of  Medicine  and  Surgery 

It  is  a  wonderful  triumph,  showing  what  ingenuity,  skill,  and  enterprise  can  effect  if  supported  by  a  suffi- 
cient number  of  purchasers.  No  catchpenny  sketches  on  flimsy  material  and  with  bad  prim,  but  substantial 
lithographs  on  fine  paper  and  with  a  bold  and  legible  type.  The  drawings  are  ot  the  first  class,  and  the  light 
and  shade  so  liberally  provided  for,  that  the  most  ample  expression,  with  great  clearness  and  sharpness  of 
outline,  is  secured. —  Dublin  Medical  Press. 

Our  hearty  good  wishes  attend  this  work,  which  promises  to  supply,  when  complete,  a  far  better  series  of 
delineations  of  surgical  regions  than  has  been  yet  given,  and  at  a  price  as  low  as  that  of  the  most  ordinary 
series  ot  illustrations. —  The  British  and  Foreign  Medico- Chirurgical  Review. 

The  plates  continue  to  be  of  the  same  excellent  character  thai  we  have  before  ascribed  to  them,  and  their 
description  all  that  might  naturally  be  expected  from  so  good  an  anatomist  as  Mr.  Macli<e.  The  work  ousht 
to  be  in  the  possession  of  every  one,  for  it  really  forms  a  valuable  addition  to  a  surgical  library.—  The  Medi- 
cal Times. 

It  is,  and  it  must  be  unique,  for  the  practical  knowledge  of  the  surgeon,  the  patience  and  skill  of  the  dissec- 
tor, in  combination  with  the  genius  of  the  artist,  as  here  displayed,  have  never  before  been,  and  perhaps, 
never  will  be  again  associated  to  a  similar  extent  in  the  same  individual.—  Lancet 

The  plates  are  accurate  and  truthful;  and  there  is  but  one  word  in  the  English  language  descriptive  of 
the  letter  press — faultless. 

For  the  quality,  it  is  the  cheapest  work  that  we  have  seen,  and  will  constitute  a  valuable  contribution  to 
the  surgeon's  library. — The  N.  W.  Medical  and  Surgical  Journal. 


12  BLANCHARD   &   LEA'S   PUBLICATIONS.—  (Anatomy.) 

SHARPEY  AND  QUAIN'S  ANATOMY.— Lately  Issued. 

HUMAN    A~N  ATOMY, 

BY    JONES    QUAIN,   M.D. 

FROM     THE    FIFTH     LONDON     EDITION. 

EDITED  BY 

RICHARD  QUAIN,  F.R.  S., 

AND 

WILLIAM  SHARPEY,  M.D.,  F.R.S., 

Professors  of  Anatomy  and  Physiology  in  University  College,  London. 
REVISED,   WITH    WOTES   AND   ADDITIONS* 

BY  JOSEPH  LEIDY,  M.  D. 

Complete  in  Two  large  Octavo  Volumes,  of  about  Thirteen  Hundred  Pages. 

BEAUTIFULLY   ILLUSTRATED 
With  over  Five  Hundred  Engravings  on  Wood. 

We  have  here  one  of  the  best  expositions  of  the  present  state  of  anatomical  science  extant.  There  is  not 
probably  a  work  to  be  found  in  the  English  language  which  contains  so  complete  an  account  of  the  progress 
and  present  state  of  general  and  special  anatomy  as  this.  By  the  anatomist  this  work  must  be  eagerly 
sought  for,  and  no  student's  library  can  be  complete  without  it.—  The  N.  Y.  Journal  of  Medicine. 

We  know  of  no  work  which  we  would  sooner  see  in  the  hands  of  every  student  of  this  branch  of  medical 
science  than  Sharpey  and  Quain's  Anatomy. —  The  Western  Journal  of  Medicine  and  Surgery. 

It  may  now  be  regarded  as  the  most  complete  and  best  posted  up  work  on  anatomy  in  the  language.  It 
will  be  found  particularly  rich  in  general  anatomy.—  The  Charleston  Medical  Journal. 

We  believe  we  express  the  opinion  of  all  who  have  examined  these  volumes,  that  there  is  no  work  supe- 
rior to  them  on  the  subject  which  they  so  ably  describe. — Southern  Medical  and  Surgical  Journal. 

It  is  one  of  the  most  comprehensive  and  best  works  upon  anatomy  in  the  English  language.  It  is  equally 
valuable  to  the  teacher,  practitioner,  and  student  in  medicine,  and  to  the  surgeon  in  particular. —  The  Ohio 
Medical  and  Surgical  Journal. 

To  those  who  wish  an  extensive  treatise  on  Anatomy,  we  recommend  these  handsome  volumes  as  the  best 
that  have  ever  issued  from  the  English  or  American  Press.— The  N.  W.  Medical  and  Surgical  Journal. 

We  believe  that  any  country  might  safely  be  challenged  to  produce  a  treatise  on  anatomy  so  readable,  so 
clear,  and  so  full  upon  all  important  topics. — British  and  Foreign  Medico-Chirurgical  Review. 

It  is  indeed  a  work  calculated  to  make  an  era  in  anatomical  study,  by  placing  before  the  student  every  de- 
partment of  his  science,  with  a  view  to  the  relative  importance  of  each ;  and  so  skillfully  have  the  different 
parts  been  interwoven,  that  no  one  who  makes  this  work  the  basis  of  his  studies  will  hereafter  have  any  ex- 
cuse for  neglecting  or  undervaluing  any  important  particulars  connected  with  the  structure  of  the  human 
frame ;  and  whether  the  bias  of  his  mind  lead  him  in  a  more  especial  manner  to  surgery,  physic,  or  physiolo- 
gy, he  will  find  here  a  work  at  once  so  comprehensive  and  practical  as  to  defend  him  from  exclusiveness  on 
the  one  hand,  and  pedantry  on  the  other.—  Monthly  Journal  and  Retrospect  of  the  Medical  Sciences- 

We  have  no  hesitation  in  recommending  this  treatise  on  anatomy  as  the  most  complete  on  that  subject  in 
the  English  language  ;  and  the  only  one.  perhaps,  in  any  language,  which  brings  the  state  of  knowledge  for- 
ward to  the  most  recent  discoveries. —  The  Edinburgh  Medical  and  Surgical  Journal 

Admirably  calculated  to  fulfil  the  object  for  which  it  is  intended. — Provincial  Medical  Journal. 

The  most  complete  Treatise  on  Anatomy  in  the  English  language. — Edinburgh  Medical  Journal. 

There  is  no  work  in  the  English  language  to  be  preferred  to  Dr.  Quain's  Elements  of  Anatomy. — London 
Journal  of  Medicine. 


THE  STUDENT'S  TEXT-BOOK  OF  ANATOMY. 
NEW   AND   IMPROVED   EDITION  — JUST   ISSUED. 

A  SYSTEM  OF  HUMAN   ANATOMY, 

GENERAL    AND    SPECIAL. 

BY  ERASMUS  WILSON,  M.  D. 

FOURTH    AMERICAN    FROM  THE  LAST  ENGLISH   EDITION. 
EDITED  BY  PAUL  B.  GODDARD,  A.  M.,  M.  D. 

WITH    TWO   HUNDRED   AND   FIFTY    ILLUSTRATIONS. 

Beautifully  printed,  in  one  large  octavo  volume  of  nearly  six  hundred  pages. 

In  many,  if  not  all  the  Colleges  of  the  Union,  it  has  become  a  standard  text-book.  This,  of  itself,  is  sufficiently 
expressive  of  its  value.  A  work  very  desirable  to  the  student;  one,  the  possession  of  which  will  greatly 
facilitate  his  progress  in  the  study  of  Practical  Anatomy.— New  York  Journal  of  Medicine. 

Its  author  ranks  with  the  highest  on  Anatomy.—  Southern  Medical  and  Surgical  Journal. 

It  offers  to  the  student  all  the  assistance  that  can  be  expected  from  such  a  work. — Medical  Examiner. 

The  most  complete  and  convenient  manual  for  the  student  we  possess. — American  Journal  of  Med .  Science. 

In  every  respect  this  work,  as  an  anatomical  guide  for  the  student  and  practitioner,  merits  our  warmest 
and  most  decided  praise. — London  Medical  Gazette. 


BLANCHARD  &  LEA'S  PUBLICATIONS.-Unafomy.)  13 

HORNER'S    ANATOMY. 
MUCH  IMPROVED  J1JVD  ENLARGED  ElHTlOJ\\—(-Ju»t  Ready.) 

SPECIAL  ANATOMY  AND  HISTOLOGY. 

BY  WILLIAM  E.  HORNER,  M.  D., 

Professor  of  Anatomy  in  the  University  of  Pennsylvania,  &c. 

EIGHTH   EDITION. 
EXTENSIVELY  REVISED  AND  MODIFIED    TO    1851. 

In  two  large  octavo  volumes,  handsomely  printed,  with  several  hundred  illustrations. 

This  work  has  enjoyed  a  thorough  and  laborious  revision  on  the  part  of  the  author,  with  the 
view  of  bringing  it  fully  up  to  the  existing  state  of  knowledge  on  the  subject  of  general  and  special 
anatomy.  To  adapt  it  more  perfectly  to  the  wants  of  the  student,  he  has  introduced  a  large  number 
of  additional  wood  engravings,  illustrative  of  the  objects  described,  while  the  publishers  have  en- 
deavored to  render  the  mechanical  execution  of  the  work  worthy  of  the  extended  reputation  which 
it  has  acquired.  The  demand  which  has  carried  it  to  an  EIGHTH  EDITION  is  a  sufficient  evidence 
of  the  value  of  the  work,  and  of  its  adaptation  to  the  wants  of  the  student  and  professional  reader. 


NEW  AND  CHEAPER  EDITION  OF 
SJHITH  &  UOttJTEWS   JUTJLTOJfllCjl 

AN   ANATOMICAL  ATLAS, 

ILLUSTRATIVE  OF  THE  STRUCTURE  OF  THE  HUMAN  BODY. 
BY  HENRY  H.  SMITH,  M.  D.,  &c. 

UNDER    THE  SUPERVISION    OF 

WILLIAM  E.    HORNER,    M.D., 

Professor  of  Anatomy  in  the  University  of  Pennsylvania. 
In  one  volume,  large  imperial  octavo,  with  about  six  hundred  and  fifty  beautiful  figures. 

With  the  view  of  extending  the  sale  of  this  beautifully  executed  and  complete  "Anatomical  Atlas,"  the 
publishers  have  prepared  a  new  edition,  printed  on  both  sides  of  the  page,  thus  materially  reducing  its  cost, 
and  enabling  them  to  present  it  at  a  price  about  forty  per  cent,  lower  than  former  editions,  while,  at  the  same 
time,  the  execution  of  each  plate  is  in  no  respect  deteriorated,  and  not  a  single  figure  is  omitted. 

These  figures  are  well  selected,  and  present  a  complete  and  accurate  representation  of  that  wonderful 
fabric,  the  human  body.  The  plan  of  this  Atlas,  which  renders  it  so  peculiarly  convenient  for  the  student,  and 
its  superb  artistical  execution,  have  been  already  pointed  out.  We  must  congratulate  the  student  upon  the 
completion  of  this  Atlas,  as  it  is  the  most  convenient  work  of  the  kind  that  has  yet  appeared  ;  and  we  must 
add,  the  very  beautiful  manner  in  which  it  is  "got  up"  is  so  creditable  to  the  country  as  to  be  flattering 
to  our  national  pride. — American  Medical  Journal. 


HORNER'S  DISSECTOR. 

THE   UNITED   STATES    DISSECTOR; 

Being  a  new  edition,  with  extensive  modifications,  and  almost  re-written,  of 

"HORNER'S   PRACTICAL    ANATOMY." 
In  one  very  neat  volume,  royal  12mo.,  of  440  pages,  with  many  illustrations  on  wood. 


WILSON'S  DISSECTOR,  New  Edition— (Now  Ready,  1851.) 

THE  DISSECTOR;^ 

OR,  PRACTICAL.   AND  SURGICAL  ANATOMY. 

BY  ERASMUS  WILSON. 

MODIFIED    AND    RE-ARRANGED    BY 
PAUL  BECK  GODDARD,  M.  D. 

A  NEW  EDITION,  WITH  REVISIONS  AND  ADDITIONS. 

In  one  large  and  handsome  volume,  royal  12mo.,  with  one  hundred  and  fifteen  illustrations. 

In  passing  this  work  again  through  the  press,  the  editor  has  made  such  additions  and  improve- 
ments as  the  advance  of  anatomical  knowledge  has  rendered  necessary  to  maintain  the  work  in  the 
high  reputation  which  it  has  acquired  in  the  schools  ol  the  United  States  as  a  complete  and  faithful 
guide  to  the  student  of  practical  anatomy.  A  number  of  new  illustrations  have  been  added,  espe- 
cially in  the  portion  relating  to  the  complicated  anatomy  of  Hernia.  In  mechanical  execution  the 
work  will  be  found  superior  to  former  editions. 


14  BLANC  HARD  &  LEA'S  PUBLICATIONS.— (Physiology.) 

WORKS  BY  W,  B,  CARPENTER,  M  D, 

COMPJinATI  YE    /»  nvSXO  LOG  Y—(JVow  Ready.) 
PRINCIPLES  OF 

GENERAL  AND  COMPARATIVE  PHYSIOLOGY, 

INTENDED  AS  AN  INTRODUCTION  TO  THE  STUDY  OF 

HUMAN    PHYSIOLOGY; 

AND  AS  A  GUIDE  TO  THE  PHILOSOPHICAL  PURSUIT  OF 

NATURAL   HISTORY. 

FROM  THE  THIRD  IMPROVED  AND  ENLARGED  LONDON  EDITION. 
In  one  very  large  and  handsome  octavo  volume,  with  several  hundred  beautiful  illustrations. 

In  presenting  to  the  American  public  this  valuable  and  important  work,  the  publishers  feel  that 
they  are  supplying  a  want  which  has  Jong  existed,  as  the  now  antiquated  treatise  of  Roget,  at 
present  nearly  out  of  print,  is  the  only  one,  having  pretensions  to  completeness,  which  has  beea 
accessible  to  the  student  in  this  country.  The  present  work  will  be  found  fully  on  a  level  with 
the  most  advanced  state  of  the  extended  science  on  which  it  treats,  the  author  having  devoted 
several  years  to  the  revision  and  improvement  of  his  new  edition,  sparing  no  labor  to  ensure  its 
completeness  and  accuracy.  The  illustrations  are  exceedingly  numerous,  and  the  whole  is  printed 
in  the  very  best  manner,  forming  one  of  the  handsomest  volumes  ever  issued  in  this  country. 

I  recommend  to  your  perusal  a  work  recently  published  by  Dr.  Carpenter.  It  has  this  advantage,  it  is  very 
much  up  to  ihe  prei-eiit  state  of  knowledge  on  the  subject.  It  is  written  in  a  clear  style,  and  is  well  illus- 
trated.— Professor  Sharpey's  Introductory  Lecture. 

In  Dr.  Carpenter's  work  will  be  found  the  best  exposition  we  possess  of  all  that  is  furnished  by  compara- 
tive anatomy  to  our  knowledge  of  the  nervous  system,  as  well  as  to  the  more  general  principles  of  life  and 
organization  —Dr.  Holland's  Medical  Notes  and  Reflections. 

See  Dr.  Carpenter's  tb  Principles  of  General  and  Comparative  Physiology" — a  work  which  makes  me  proud 
to  think  he  was  once  my  pupil.— Dr.  Elliotsorfs  Physiology. 


CARPENTER'S  ELEMENTS  OF  PHYSIOLOGY,  New  and  Improved  Edition— (Just  Ready.) 

ELEMENTS  OF~PHYSIOLOGY; 

INCLUDING    PHYSIOLOGICAL    ANATOMY. 

FOR  THE  USE  OF  THE  MEDICAL  STUDENT. 

WITH    NEARLY   TWO    HUNDRED    ILLUSTRATIONS. 
Second  American,  front  t  It  t  Second  London  Edition* 

In  one  handsome  octavo  volume,  of  about  six  hundred  pages. 

Of  his  different  treatises  on  Physiology,  the  present  work  seems  to  us  to  be  bestadapted  to  the  requirements 
of  the  student,  and  to  constitute,  on  this  account,  a  good  text-book  for  the  lecturer.  The  author  in  his  preface, 
directs  atteniion  to  the  copiousness  and  beauty  of  the  illustrations;  and  they  who  make  any  remarks  on  the 
American  edition,  may.  with  great  propriety,  repeat  the  encomium.—  Bulletin  of  Medical  Science. 

To  say  that  it  is  the  best  manual  of  Physiology  now  before  the  public,  would  not  do  sufficient  justice  to  the 
author  — Buffalo  Med.  Journal. 

In  his  former  works  it  would  seem  that  he  had  exhausted  the  subject  of  Physiology.  In  the  present,  he 
gives  the  essence,  as  it  were,  of  the  whole.— TV.  Y.  Journal  of  Medirine. 

The  best  and  most  complete  expos<§  of  modern  physiology,  in  one  volume,  extant  in  the  English  language. 
—  St.  Louis  Med.  Journal. 

Those  who  have  occasion  for  an  element«ry  treatise  on  physiology,  cannot  do  better  than  to  possess  them- 
selves of  the  manual  of  Dr.  Carpenter.— Medical  Examiner. 


CARPENTER'S  HUMAN  PHYSIOLOGY. 

PRINCIPLES  OF  HUMAN  PHYSIOLOGY. 

WITH  THEIR  CHIEF  APPLICATIONS  TO 
PATHOLOGY,  HYGIENE,  AND  FORENSIC  MEDICINE. 

FOURTH  AMERICAN  EDITION,  WITH  EXTENSIVE  ADDITIONS  AND  IMPROVEMENTS  BY  THE  AUTHOR. 

With  Two  Lithographic  Plates,  and  S04  wood-cuts, 

In  one  large  and  handsomely  printed  octavo  volume  of  over  seven  hundred  and  fifty  pages. 

In  preparing  a  new  edition  of  this  very  popular  text-book,  the  publishers  have  had  it  completely  revised 
by  the  author,  who,  without  materially  increasing  its  bulk,  has  embodied  in  it  all  the  recent  investigations 
and  discoveries  in  physiological  science,  and  has  rendered  it  in  every  respect  on  a  level  with  the  improvement* 
of  the  day.  Although  the  number  of  the  wood-»  ngravings  has  been  but  little  increased,  a  considerable  change 
will  be  found,  many  new  and  interesting  illustrations  having  been  introduced  in  place  of  others  which  were 
considered  of  minor  importance,  or  which  the  advance  of  science  had  shown  to  be  imperfect,  while  the  plates 
have  been  altered  and  redrawn  under  the  supervision  of  the  author  by  a  competent  London  artist.  In  passing 
the  volume  through  the  press  in  this  country,  the  services  of  a  professional  gentleman  have  been  secured,  in 
order  to  insure  the  accuracy  so  necessary  to  a  scientific  work.  Notwithstanding  these  improvements,  the 
price  of  the  volume  is  maintained  at  its  former  moderate  rate. 

In  recommending  this  work  to  their  classes.  Professors  of  Physiology  can  rely  on  their  being  always  able 
to  procure  editions  brought  thoroughly  up  with  the  advance  of  science. 


BLANCHARD  &  LEA'S  PUBLICATIONS.— (Physiology.)  •          15 

DUNGLISON'S     PHYSIOLOGY. 
New  and  much  Improved  Edition.— (Just  Issued.) 

HUMAN    PHYSIOLOGY. 

BY  ROBLEY  DUNGLISON,  M.  D., 

Professor  of  the  Institutes  of  Medicine  in  the  Jefferson  Medical  College,  Philadelphia,  etc.  etc. 

SEVENTH  EDITION. 

Thoroughly  revised  and  extensively  modified  and  enlarged, 
WITH    NEARLY    FIVE    HUNDRED    ILLUSTRATIONS. 

In  two  large  and  handsomely  printed  octavo  volumes,  containing  nearly  1450  pages. 
On  no  previous  revision  of  this  work  has  the  author  bestowed  more  care  than  on  the  present,  it 
having  been  subjected  to  an  entire  scrutiny,  not  only  as  regards  the  important  matters  of  which  it 
treats,  but  also  the  language  in  which  they  are  conveyed  ;  and  on  no  former  occasion  has  he  felt 
as  satisfied  with  his  endeavors  to  have  the  work  on  a  level  with  the  existing  state  of  the  science. 
Perhaps  at  no  time  in  the  history  of  physiology  have  observers  been  more  numerous,  energetic, 
and  discriminating  than  within  the  last  few  years.  Many  modifications  of  fact  and  inference  have 
consequently  taken  place,  which  it  has  been  necessary  for  the  author  to  record,  and  to  express  his 
views  in  relation  thereto.  On  the  whole  subject  of  physiology  proper,  as  it  applies  to  the  functions 
executed  by  the  different  organs,  the  present  edition,  the  author  flatters  himself,  will  therefore  be 
found  to  contain  the  views  of  the  most  distinguished  physiologists  of  all  periods. 

The  amount  of  additional  matter  contained  in  this  edition  may  be  estimated  from  the  fact  that 
the  mere  list  of  authors  referred  to  in  its  preparation  alone  extends  over  nine  large  and  closely  printed 
pages.  The  number  of  illustrations  has  been  largely  increased,  the  present  edition  containing  four 
hundred  and  seventy-four,  while  the  last  had  but  three  hundred  and  sixty-eight;  while,  in  addition 
to  this,  many  new  and  superior  wood-cuts  have  been  substituted  for  those  which  were  not  deemed 
sufficiently  accurate  or  satisfactory.  The  mechanical  execution  of  the  work  has  also  been  im- 
proved in  every  respect,  and  the  whole  is  confidently  presented  as  worthy  the  great  and  continued 
favor  which  it  has  so  long  received  from  the  profession. 

It  has  long  since  taken  rank  as  one  of  the  medical  classics  of  our  language.  To  say  that  it  is  by  far  the  best 
text-book  of  physiology  ever  published  in  this  country,  is  but  echoing  the  general  testimony  of  the  profession. 
—N.  Y.  Journal  of  Medicine. 

The  most  full  and  complete  system  of  Physiology  in  our  language. —  Western  Lancet. 

The  most  complete  and  satisfactory  system  of  Physiology  in  the  English  language. — Amer.  Med.  Journal. 

Tlie  best  work  of  the  kind  in  the  English  language. — Sitlimans,  Journal. 

We  have,  on  two  former  occasions,  brought  this  excellent  work  under  the  notice  of  our  readers,  and  we 
have  now  only  to  say  that,  instead  of  failing  behind  in  the  rapid  march  of  physiological  science,  each  edition 
brings  it  nearer  to  the  van. — British  and  Foreign  Medical  Review. 

A  review  of  such  a  well-known  work  would  be  out  of  place  at  the  present  time.  We  have  looked  over  it, 
and  find,  what  we  knew  would  be  the  case,  that  Dr.  Dunglison  has  kept  pace  with  the  science  to  which  he 
has  devoted  so  much  study,  and  of  which  be  is  one  of  the  living  ornaments.  We  recommend  the  work  to  the 
medical  studeut  as  a  valuable  text-hook,  and  10  all  inquirers  into  Natural  Science,  as  one  which  will  well 
and  delightfully  repay  perusal. —  The  New  Orleans  Medical  and  Surgical  Journal. 

KIRKES    AND  PAGET'S  PHYSIOI*OGY.-(l.ately  Issued.) 

A  MANUAL  OF  PHYSIOLOGY, 

FOR    THE    USE    OF    STUDENTS. 
BY  WILLIAM  SENHOUSE  KIKKES,  M.  D., 

ASSISTED  BY  JAMES  FAGET, 

Lecturer  on  General  Anatomy  and  Physiology  in  St.  Bartholomew's  Hospital. 
In  one  handsome  volume,  royal  12mo.,  of  550  pages,  with  118  wood-cuts. 

An  excellent  work,  and  for  students  one  of  the  best  within  reach.—  Boston  Medical  and  Surgical  Journal. 
One  of  the  best  little  books  on  Physiology  which  we  possess.—  Brai th waiters  Retrospect. 
Particularly  adapted  to  those  who  desire  to  possess  a  concise  digest  of  the  facts  of  Human  Physiology.— 
British  and  Foreign  Med.- Chirurg.  Review. 

One  of  the  best  treatises  which  can  be  put  into  the  hands  of  the  student.—  London  Mfdicnl  Gazette. 
We  conscientiously  recommend  it  as  an  admirable  "  Handbook  of  Physiology."— London  Jour,  of  Medicine. 

SOLLY  ON   THE    BRAIN. 

THE  HUMAN  BRAIN;  ITS  STRUCTURE,  PHYSIOLOGY,  AND  DISEASES. 

WITH    A   DESCRIPTION    OF   THE  TYPICAL   FORM    OF   THE   BRAIN   IN   THE   ANIMAL   KINGDOM. 

BY  SAMUEL  SOLLY,  F.  R.  S.,  &c  , 

Senior  Assistant  Surgeon  to  the  St.  Thomas'  Hospital,  &c. 

From  the  Second  and  much  Enlarged  London  Edition.    In  one  octavo  volume,  with  120  Wood-cuts. 

HARRISON  ON  THE  NERVES.— An  Essay  towards  a  correct  theory  of  the  Nervous  System.    In  one 

octavo  volume.  292  pae^  s. 
MATTEUCCI  O\  LIVING  BEINGS.—  Lectures  on  the  Physical  Phenomena  of  Living  Beings.    Edited 

by  Pereira.     In  one  neat  royal  12mo.  volume,  extra  cloth,  with  cuts — 38S  pages. 
ROfiET'S  PHYSIOLOGY.— A  Treatise  on  Animal  and  Vegetable  Physiology,  with  over  400  illustrations  on 

wood.    In  two  octavo  volumes,  cloth 

ROGET'S  OUTLINES  —Outlines  of  Physiology  and  Phrenology.    In  one  octavo  volume,  cloth— 516  pages. 
ON  THE   CONNECTION    BETWEEN   PHYSIOLOGY    AND   INTELLECTUAL   SCIENCE.    In  one 

1'2mo.  volume,  paper,  price  25  cents. 
TODD  &  BOWMAN'S  PHYSIOLOGY —Physiological  Anatomy  and  Physio'ogy  of  Man.  With  numerous 

handsome  wood-cuts.    Parts  I,  II,  aud  III,  in  one  8vo.  volume,  552  pp.    Part  IV  will  complete  the  work. 


16  BLANCHARD    &  LEA'S  PUBLICATIONS.— (Pathology.") 

WIL,1,IJ1M&  PnTJVCIPLES—JYew  and  Enlarged  Edition. 

PRINCIPLES  OF  MEDICINE; 

Comprising  General  Pathology  and  Therapeutics, 

AND  A  BRIEF  GENERAL  VIEW  OF 

ETIOLOGY,  NOSOLOGY,   SEMEIOLOGY,  DIAGNOSIS,   PROGNOSIS,   AND   HYGIENICS, 
BY  CHARLES  J.  B.  WILLIAMS,  M.  D.,  F.  R.  S., 

Fellow  of  the  Royal  College  of  Physicians.  &c. 

EDITED,  WITH  ADDITIONS,  BY  MEREDITH  CLYMER,  M.  D., 

Consulting  Physician  to  the  Philadelphia  Hospital,  &c.  &c. 
THIRD    AMERICAN,    FROM    THE    SECOND    AND    ENLARGED    LONDON    EDITION. 

In  one  octavo  volume,  of  440  pages. 
BIIXING'S  PRINCIPLES,  NEVT  EDITION— (Just  Issued.) 

THE  PRINCIPLES  OF  MEDICINE. 

BY  ARCHIBALD  BILLING,  M.  D.,  &c. 

Second  American  from  the  Fifth  and  Improved  L,ondon  Edition. 

In  one  handsome  octavo  volume,  extra  cloth,  250  pages. 

We  can  strongly  recommend  Dr.  Billing's  "Principles"  as  a  code  of  instruction  which  should  be  con- 
stantly present  to  the  mind  of  every  well-informed  and  philosophical  practitioner  of  medicine.—  Lancet. 

MANUALS  ON  THE  BLOOD  AND  URINE. 

In  two  handsome  volumes  royal  12mo.,  extra  cloth. 
With  numerous  Illustrations  on  Stone  and  Wood. 

VOLUME  I,  OF  FOUR  HUNDRED  AND  SIXTY  LARGE  PAGES.  CONTAINS 

I.  A  Practical  Manual  on  the  Blood  and  Secretions  of  the  Human  Body.     BY  JOHN  WILLIAM 
GRIFFITH,  M.  D.,  &c. 

II.  On  the  Analysis  of  the  Blood  and  Urine  in  health  and  disease,  and  on  the  treatment  of  Urinary 
diseases.     BY  G.  OWEN  REESE,  M.  D.,  F.  R.  S.,   &c.  &c. 

III.  A  Guide  to  the  Examination  of  the  Urine  in  health  and  disease.  BY  ALFRED  MARKWICK. 

VOLUME  II,  NOW  READY,  CONSISTS  OF 

I.  Urinary  Deposits,  their  Diagnosis,  Pathology,  and  Therapeutical  Indications.     By  GOLDING 
BIRD,  M.  D.     A  new  American  from  the  third  and  improved  London  edition.     With  over  sixty 
illustrations. 

II.  Renal  Affections,  their  Diagnosis  and  Pathology.     By  CHARLES  FRICK,  M.  D.     With  illus- 
trations. 

Either  of  these  volumes  may  be  had  separately,  as  also  BIRD  ON  URINARY  DEPOSITS,  and 
FRICK  ON  RENAL  AFFECTIONS,  each  in  one  handsome  12mo.  volume,  extra  cloth. 
The  importance  now  attached  to  the  Diagnosis  of  the  Blood  and  Urine,  and  the  rapid  increase  of  our  know- 
ledge respecting  the  pathological  conditions  of  the  fluids  of  the  human  body,  have  induced  the  publishers  to 
present  these  manuals  in  a  cheap  and  convenient  form,  embracing  the  results  of  the  most  recent  observers  in 
a  practical  point  of  view.    On  the  subject  of  the  chemical  and  microscopical  examinations  of  these  fluids, 
they  would  also  call  the  attention  of  the  student  to  BOWMAN'S  MEDICAL  CHEMISTKY,  and  SIMON'S  ANIMAL 
CHEMISTRY.    See  p.  30. 

OF  THE  CAUSES,  NATURE,  AND  TREATMENT  OF 

PALSY  AND  APOPLEXY, 

And  of  the  Forms,  Seats,  Complications,  and  Morbid  Relations  of  Paralytic  and 

Apoplectic  Diseases. 

BY  JAMES  COPLAND,  M.  D.,  F.  R.  S.,  &c. 
In  one  volume.    (Just  Issued.) 


THE  PATHOLOGICAL  ANATOMY  OF  THE  HUMAN  BODY, 

BY  JULIUS  VOGEL,  M.  D.,  &c. 

Translated  from  the  German,  with  Additions, 

BY  GEORGE  E.  DAY,  M.  D.,  &c. 

ILLUSTRATED    BY  UPWARDS   OF   ONE   HUNDRED    FIGURES,   PLAIN    AND    COLORED. 

In  one  neat  octavo  volume. 


ABERCROMBIE  ON  THE  BRATN.— Pathological  and  Practical  Researches  on  Diseases  of  the  Brain  and 

Spinal  Cord.     A  ne.w  edition,  in  out-  small  8vo.  volume,  pp.  324. 
BURROWS  ON  CEREBRAL  CIRCULATION.— On  Disorders  of  the  Cerebral  Circulation,  and  on  the 

Connection  between  Affections  of  the  Brain  and  Diseases  of  the  Heart.  In  one  Svo.  vol.,  with  colored  plates, 

pp.  216. 
BLAKISTON  ON  THE  CHEST.— Practical  Observations  on  certain  Diseases  of  the  Chest,  and  on  the 

Principles  of  Auscultation.    In  one  volume,  8vo.,  pp.  3S4. 
HASSE'S  PATHOLOGICAL  ANATOMY.— An  Anatomical  Description  of  the  Diseasesof  Respiration  and 

Circulation.    Translated  and  Edited  by  Swaine.     In  one  volume,  Svo..,  pp.  379. 
HUGHES  ON  THE  LUNGS  AND  HEA.RT,— Clinical  Introduction  lo  the  Practice  of  Auscultation,  and 

other  modes  of  Physical  Diagnosis.    In  one  12mo.  volume,  with  a  plate,  pp.  270. 


BLANCHARD  &   LEA'S    PUBLICATIONS.— (Practice  of  Medicine.')         17 

DUNGLISON'S  PRACTICE  OF  MEDICINE. 

ENLARGED  AND  IMPROVED  EDITION. 

THE    PRACTICE~OF    MEDICINE. 

A  TREATISE   ON 

SPECIAL  PATHOLOGY  AND  THERAPEUTICS. 

THIRD    EDITION. 

BY  ROBLEY  DUNGLISON,  M.  D., 

Professor  of  the  Institutes  of  Medicine  in  the  Jefferson  Medical  College  ;  Lecturer  on  Clinical  Medicine,  &e. 
In  two  large  octavo  volumes,  of  fifteen  hundred  pages. 

The  student  of  medicine  will  find,  in  these  two  elegant  volumes,  a  mine  of  facts,  a  gathering 
of  precepts  and  advice  from  the  world  of  experience,  that  will  nerve  him  with  courage,  and  faith- 
fully direct  him  in  his  efforts  to  relieve  the  physical  sufferings  of  the  race. — Boston  Medical  and 
Surgical  Journal. 

Upon  every  topic  embraced  in  the  work  the  latest  information  will  be  found  carefully  posted  up. 
Medical  Examiner. 

It  is  certainly  the  most  complete  treatise  of  which  we  have  any  knowledge.  There  is  scarcely  a 
disease  which  the  student  will  not  find  noticed. —  Western  Journal  of  Medicine  and  Surgery. 

One  of  the  most  elaborate  treatises  of  the  kind  we  have.— Southern  Medical  and  Surg.  Journal. 


A  New  Work.     Now  Ready. 

DISEASES  OF  THE  HEART,  LUNGS,  AND  APPENDAGES ; 

THEIR   SYMPTOMS  AND  TREATMENT.' 
BY  W.  H.  WALSHE,  M.D., 

Professor  of  the  Principles  and  P»  actice  of  Medicine  in  University  College,  London,  (f-c. 

In  one  handsome  volume,  large  royal  12mo. 

The  author's  design  in  this  work  has  been  to  include  within  the  compass  of  a  moderate  volume,  all  really 
essential'  facts  bearing  upon  ttie  symptoms,  physical  signs,  and  treatment  of  pulmonary  and  cardiac  diseases. 
To  accomplish  this  the  first  part  of  the  work  is  devoted  to  the  description  of  the  various  modes  of  physical 
diagnosis,  auscultation,  percussion,  mensuration,  &c.,  which  are  fully  and  clearly,  hut  succinctly  entered; 
imo,  both  as  respects  their  theory  and  clinical  phenomena.  In  the  second  part,  the  various  diseases  of  the 
heart,  lungs,  and  great  vessels  are  considered  in  regard  to  symptoms,  physical  signs  and  treatment,  with 
numerous  references  to  cases.  The  eminence  of  the  author  is  a  guarantee  to  the  practitioner  and  student 
that  the  work  is  one  of  practical  utility  in  facilitating  the  diagnosis  and  treatment  of  a  large,  obscure  and 
important  class  of  diseases. 


THE    GREAT    MEDICAL    LIBRARY. 

•    THE  CYCLOPEDIA  OFTfiACTICAL  MEDICINE; 

COMPRISING 

Treatises  on  the  Nature  and  Treatment  of  Diseases,  Materia  Medica,  and  Thera- 
peutics, Diseases  of  "Women  and  Children,  Medical  Jurisprudence,  &c.  &c. 

EDITED    BY 

JOHN  FORBES,  M.  D.,  F.  R.  S.,  ALEXANDER  TWEED  IE,  M.  D.,  F.  R.  S. 

AND  JOHN  CONNOLLY,  M.  D. 

Revised,  with  Additions, 

BY  ROBLEY  DUNGLISON,  M.  D. 

THIS  WORK  IS  NOW  COMPLETE,  AND   FORMS  FOUR  LARGE  SUPER- ROYAL  OCTAVO  VOLTTMES, 

Containing  Thirty-two  Hundred  and  Fifty-four  unusually  large  Pages  in  Double  Columns,  Printed 
on  Good  Paper,  with  a  new  and  clear  type. 

THE   WHOLE  WELL   AND   STRONGLY    BOUND    WITH    RAISED    BANDS    AND   DOUBLE    TITLES. 

This  work  contains  no  less  than  FOUR  HUNDRED  AND  EIGHTEEN  DISTINCT  TREATISES, 

By  Sixty-eight  distinguished  Physicians. 

The  most  complete  work  on  Practical  Medicine  extant;  or,  at  least,  in  our  language. — Buffalo  MedicoA 
and  Surgical  Journal. 

For  reference,  it  is  above  all  price  to  every  practitioner. —  Western  Lancet. 

One  of  the  most  valuable  medical  publications  of  the  day — as  a  work  of  reference  it  is  invaluable, — 
Western  Journal  of  Medicine  and  Surgery. 

It  has  been  to  us.  boih  as  learner  and  teacher,  a  work  for  ready  and  frequent  reference,  one  in  which 
modern  English  medicine  is  exhibited  in  the  most  advantageous  fight. — Medical  Examiner. 

We  rejoice  that  this  work  is  to  be  placed  within  the  reach  of  the  profession  in  this  country,  it  being  unques- 
tionably one  of  very  great  value  to  the  practitioner.  This  estimate  of  it  has  not  been  formed  from  a  ha«ty  ex- 
aminHtion,  but  after  an  intimate  acquaintance  derived  from  frequent  consuhation  of  it  (hiring  the  past  nine  or 
ten  years.  The  editors  are  practitioner.*  of  established  reputation,  and  tbe  list  of  conlributors  embraces  many 
of  the  most  eminent  professor?  and  teachers  of  London,  Edinburgh.  Dublin,  and  Glasgow.  It  is,  indeed,  the 
great  merit  of  this  work  that  ihe  principal  articles  have  been  furnished  by  practitioners  who  have  not  only 
devoted  especial  attention  to  the  diseases  about  which  they  have  written,  but  have  also  enjoyed  opportunities 
for  an  extensive  practical  acquaintance  with  them. — and  whose  reputation  carries  the  assurance  of  their 
competency  justly  to  appreciate  the  opinions  of  others,  while  it  stamps  their  own  doctriues  with  high  and ju»t 
authority. — American  Medical  Journal. 


18  BLANCHARD   &    LEA'S    PUBLICATIONS  —(Practice  of  Medicine.) 

WATSON'S  PRACTICE  OF  MEDICIWE-New  Edition. 

LECTURED  ON  THE 

PRINCIPLES  AND  PRACTICE  OF  PHYSIC, 

BY  THOMAS  WATSON,  M.  D.,  &o.  &o. 

Third  American,  from  the  last  London  Edition. 

REVISED,  WITH  ADDITIONS,  BY  D.  FRANCIS  CONDIE,  M.  D., 

Author  of  u  A  Treatise  on  the  Diseases  of  Children,"  &c. 

IN    ONE   OCTAVO   VOLUME, 
Of  nearly  ELEVEN  HUNDRED  LARGE  PAGES,  strongly  bound  with  raised  bands. 

To  say  that  it  is  the  very  best  work  on  the  subject  now  extant,  is  but  to  echo  the  sentiment  of  the  medical 
press  throughout  the  country. —  N.  O.  Medical  Journal. 

Of  the  text-books  recently  republished  Watson  is  very  justly  the  principal  favorite. — Holmes'1  Report  to 
Nat.  Med.  Assoc. 

By  universal  consent  the  work  ranks  among  the  very  best  text-books  in  our  language.— HI.  andlnd.  Med. 
Journal. 

Regarded  on  all  hands  as  one  of  the  very  best,  if  not  the  very  best,  systematic  treatise  on  practical  medi- 
cine extant  —  St.  Louis  Med.  Journal. 

Confessedly  one  of  the  very  best  works  on  the  principles  and  practice  of  physic  in  the  English  or  any  other 
language. — Med.  Examiner. 

As  a  text-book  it  has  no  equal;  as  a  compendium  of  pathology  and  practice  no  superior. —  /V.  Y.  Annalist. 

We  know  of  no  work  better  calculated  for  being  placed  in  the  hands  of  the  student,  and  for  a  text  book, 
on  every  important  point  the  author  seems  to  have  posted  up  his  knowledge  tcfthe  day.— Amer.  Med.  Journal. 

One  of  the  most  practically  useful  books  that  ever  was  presented  to  the  student. — N.  Y.  Med.  Journal. 


WILSON   ON   THE    SKIN. 

ON     DISEASES~~OF    THE     SKIN, 

BY  ERASMUS  WILSON,  F.  R.  S., 

Author  of"  Human  Anatomy,"  &c. 
SECOND    AMERICAN    FROM    THE    SECOND    LONDON   EDITION. 

In  one  neat  octavo  volume,  extra  cloth,  440  pages. 

Also,  to  l>e  liad  with  eight  beautifully  colored  steel  plates. 
Also,  the  plates  sold  separate,  in  hoards. 


Much  Enlarged  Edition  of  B ARTL.ETT  ON  FEVERS. 

THE  HISTORY,  DIAGNOSIS,  AND  TREATMENT  OF  THE 

FEVERS  OF  THE  UNITED  STATES, 

BY   ELISHA  BARTLETT,  M.D., 

In  one  octavo  volume  of  550  pages,  beautifully  printed  and  strongly  bound. 


CLYMER  AND  OTHERS  ON  FEVERS. 


FEVERS;   THEIR  DIAGNOSIS,  PATHOLOGY,   AND  TREATMENT, 

PREPARED    AND    EDITED,    WITH    LARGE    ADDITIONS, 
FROM  THE  ESSAYS  ON  FEVER  IN  TWEEDIE's  LIBRARY  OF  PRACTICAL  MEDICINE, 

BY    MEREDITH    CLYMER,    M.  D. 

In  one  octavo  volume  of  six  hundred  pages. 


BENEDICT'S  CHAPMAN.— Compendium  of  Chapman's  Lectures  on  the  Practice  of  Medicine.    One  neat 

volume,  8vo.,  pp.  258. 
BUDD  ON  THE  LIVER.— On  Diseases  of  the  Liver.    In  one  very  neat  Svo.  vol.,  with  colored  plates  and 

wood-cuts,  pp.  392. 
CHAPMAN'S  LECTURES.— Lectures  on  Fevers,  Dropsy,  Gout,  Rheumatism,  &c.  &c.    In  one  neat  Svo. 

volume,  pp.  450. 
ESQU1ROL  ON  INSANITY.— Mental  Maladies,  considered  in  relation  to  Medicine,  Hygiene,  and  Medical 

Jurisprudence.    Translated  by  E.  K.  Hunt,  M.  D.,  &c.     In  one  Svo.  volume,  pp.  496. 
THOMSON  ON  THE  SICK  ROOM. — Domestic  management  of  the  sick  Room,  necessary  in  aid  of  Medical 

Treatment  for  the  cure  of  Diseases.    Edited  by  R.  E.  Griffith,  M.  D.    In  one  large  royal  12ino.  volume,  with 

wood-cuts,  pp.  360. 

HOPE  ON  THE  HEART.— A  Treatise  on  the  Diseases  of  the  Heart  and  Great  Vessels.    Edited  by  Pen- 
nock.     In  one  volume,  8vo  ,  with  plates,  pp.  572. 
LALLEMAND  ON   SPERMATORRHOEA.— The  Causes,  Symptoms,  and  Treatment  of  Spermatorrhoea. 

Translated  and  Edited  by  Henry  J  McDougal.    In  one  volume,  Svo.,  pp.  320. 
PHILIPS  ON  SCROFULA.— Scrofula:  its  Nature,  its  Prevalence,  its  Causes,  and  the  Principles  of  its 

Treatment     In  one  volume,  8vo.,  with  a  plate,  pp.  350. 
WHITEHEAD  ON  ABORTION,  &c.— The  Causes  and  Treatment  of  Abortion  and  Sterility;  being  the 

Result  of  an  Extended  Practical  Inquiry  into  the  Physiological  and  Morbid  Conditions  of  the  Uterus.    In 

one  volume,  8vo.,  pp  368. 

WILLIAMS  ON  RESPIRATORY  ORGANS.— A  Practical  Treatise  on  Diseases  of  the -Respiratory  Or- 
gans; including  Diseases  of  the  Larynx,  Trachea,  Lungs,  and  Pleura;.     With  numerous  Additions  and 

Notes  by  M.  Clymer,  M.  D.     VVith  wood-cuts.     In  one  octavo  volume,  pp  508 
DAY  ON  OLD  AGE.— A  Practical  Treatise  on  the  Domestic  Management  and  more  important  Diseases  of 

Advanced  Life.     With  an  Appendix  on  a  new  and  successful  mode  of  treating  Lumbago  and  other  forms 

of  Chronic  Rheumatism.    1  vol.  8vo.,  pp.  226. 


BLANCHARD    &    LEA'S  PUBLICATIONS.— (Diseases  of  Females.}  19 

MEIGS  ON  FEMALES,  New  and  Improved  Edition — (Just  Issued,) 

WOMAN;  HER  DISEASES"  AND  THEIR  REMEDIES; 

A    SERIES    OF    LETTERS    TO    HIS    CLASS. 
BY  C.  D.  MEIGS,  M.  D., 

Professor  of  Midwifery  and  Diseases  of  Women  and  Children  in  the  Jefferson  Medical  College  of 

Philadelphia,  &c.  &c. 
In  one  large  and  beautifully  printed  octavo  volume,  of  nearly  seven  hundred  large  pages. 

"  I  am  happy  to  offer  to  my  Class  an  enlarged  and  amended  edition  of  my  Letters  on  the  Dis- 
eases of  Women  ;  and  I  avail  myself  of  this  occasion  to  return  my  heartfelt  thanks  to  them,  and 
to  our  brethren  generally,  for  the  flattering  manner  in  which  they  have  accepted  this  fruit  of  my 
labor." — PREFACE. 

The  value  attached  to  this  work  by  the  profession  is  sufficiently  proved  by  the  rapid  ex- 
haustion of  the  first  edition,  and  consequent  demand  for  a  second.  In  preparing  this  the 
author  has  availed  himself  of  the  opportunity  thoroughly  to  revise  and  greatly  to  improve 
it.  The  work  will  therefore  be  found  completely  brought  up  to  the  day,  and  in  every  way 
worthy  of  the  reputation  which  it  has  so  immediately  obtained. 

Professor  Meigs  has  enlarged  and  amended  this  great  work,  for  such  it  unquestionably  is,  having  passed 
ihe  ordeal  of  criticism  at  home  and  abroad,  but  been  improved  thereby;  for  in  this  new  edition  the  author 
luis  introduced  real  improvements,  and  increased  the  value  and  utility  of  the  book  immeasurably.  It  presents 
so  many  novel,  bright  and  sparkling-  thoughts;  such  an  exuberance  of  new  ideas  on  almost  every  page, 
that  we  confess  ourselves  Jo  have  become  enamored  with  the  book  and  its  author;  and  c%mnot  withhold 
our  congratulations  from  our  Philadelphia  confreres,  that  such  a  teacher  is  in  their  service.  We  regret  that 
our  limits  will  not  allow  of  a  more  extended  notice  of  this  work,  but  mu*t  content  ourselves  with  thus  com- 
memiiiig  it  as  worthy  of  diligent  perusal  by  physicians  as  well  as  students,  who  are  seekingto  be  thoroughly 
instructed  in  the  important  practical  subjects  of  which  it  treats — N.  Y.  Med.  Gazftte. 

It  contains  a  vast  amount  of  practical  knowledge,  by  one  who  has  accurately  observed  and  retained  the 
experience  of  many  years,  and  who  tells  ihe  result  in  a  free,  familiar,  and  pleasant  manner. — Dublin  Quar- 
terly Journal. 

There  is  an  off-hand  fervor,  a  glow  and  a  warm-heartedness  infecting  the  effort  of  Dr.  Meigs,  which  is  en- 
tirely captivating,  and  which  absolutely  hurries  the  reader  through  from  beginning  to  end.  Besides,  the 
book  teems  with  solid  instruction,  and  it  shows  the  very  highest  evidence  of  ability,  viz.,  the  clearness  with 
which  the  information  is  presented.  \Ve  know  of  no  better  test  of  one's  understanding  a  subject  than  the 
evidence  of  the  power  of  lucidly  explaining  it.  The  most  elementary,  as  well  as  the  obscurest  subjects,  un- 
der the  pencil  of  Prof.  Meigs,  are  isolated  and  made  to  stand  out  in  such  bold  relief,  as  to  produce  distinct 
impressions  upon  the  mind  and  memory  of  the  reader — The  Charleston  Medical  Journal. 

The  merits  of  the  first  edition  of  this  work  were  so  generally  appreciated,  and  with  such  a  high  degree  of 
favor  by  the  medical  profession  throughout  the  Union,  that  we  are  not  surprised  in  seeing  a  second  edition 
of  it  It  is  a  standard  work  on  the  diseases  of  females,  and  in  many  respects  is  one  of  the  very  best  of  its 
kind  in  the  English  language.  Upon  the  appearance  of  the  first  edition,  we  gave  the  work  a  cordial  recep- 
tion, and  spoke  of  it  in  the  warmest  terms  of  commendation.  Time  has  not  changed  the  favorable  estimate 
\ve  placed  upon  it,  but  has  rather  increased  our  convictions  of  its  superlative  merits.  But  we  do  not  now 
d-'eiri  it  necessary  to  say  more  than  to  commend  this  work,  on  the  diseases  of  women,  and  the  remedies 
Jor  them,  to  the  attention  of  those  practitioners  who  have  not  supplied  themselves  with  it.  The  most  select 
library  would  be  imperfect  without  it. —  The  Western  Journal  of  Medicine  and  Surgery. 

He  is  a  bold  thinker,  and  possesses  more  originality  of  thought  ai  d  style  than  almost  any  American  writer 
on  medical  subject*.  If  he  is  not  an  elegant  writer,  there  is  at  least  a  freshness— a  raciuess  in  his  mode  of 
expressing  himself— that  cannot  fail  to  draw  the  reader  after  him,  even  to  the  close  of  his  work  :  you  cannot 
i.od  over  his  pages;  he  stimulates  rather  than  narcotises  your  senses,  and  the  reader  cannot  lay  aside  these 
letters  when  once  he  enters  into  their  merits.  This,  the  second  edition,  is  much  amended  and  enlarged,  and 
affords  abundant  evidence  of  the  author's  talents  and  industry.—  N.  O  Medical  and  Surgical  Journal. 

The  practical  writings  of  Dr.  Meigs  are  second  to  none.—  The  N.  Y.  Journal  of  Medicine. 

The  excellent  practical  directions  contained  in  this  volume  give  it  great  utility,  which  we  trust  will  not  be 
lost  upon  our  older  colleagues  ;  with  some  condensation,  indeed,  we  should  think  it  well  adapted  for  trans- 
lation into  German. — ZeiUchriftfur  die  Gesammte  Medecin. 

NEW  AND  IMPROVED  EDITION-(Just  Issued.) 

A  TREATISE  ON  THE  DISEASES  OF  FEMALES, 

AND  ON  THE  SPECIAL  HYGIENE  OF  THEIR  SEX, 
BY   COLOMBAT   DE    L'ISERE,  M.  D. 

TRANSLATED,  WITH  MANY  NOTES    AND  ADDITIONS,  BY  C.  D.  MEIGS,  M.  D. 

SECOND   EDITION,    REVISED    AND    IMPROVED. 

In  one  large  volume,  octavo,  of  seven  hundred  and  twenty  pages,  with  numerous  wood-cuts. 
We  are  satisfied  it  is  destined  to  take  the  front  rank  in  this  department  of  medical  science.     It  is  in  fact  a 
complete  exposition  of  the  opinions  and  practical  methods  of  all  the  celebrated  practitioners  of  ancient  and 
modern  times.—  New  York  Jouin.  of  Medicine. 


ASH-WELL    ON    THE    DISEASES    OF    FEMALES. 

A  PRACTICAL  TREATISE  ON  THEllSEASES  PECULIAR  TO  WOMEN. 

ILLUSTRATED    BY    CASES    DERIVED    FRuM    HuSFlTAl,   AND    PRIVATE  PRACTICE. 

BY  SAMUEL  ASH  WELL,  M.  D.    WITH  ADDITIONS  BY  PAUL  BECK  GODDARD,  M.  D. 

Second  American  edition.     In  one  octavo  volume,  of  520  pages. 
One  of  the  very  best  works  ever  issued  from  the  press  on  the  Diseases  of  Females. —  Western  Lancet. 


ON  THE  CAUSES  AND  TREATMENT  OF  ABORTION   AND   STERILITY.    By  James  Whitehead, 
M.  !>.,  &c.    In  one  volume  octavo,  of  about  three  hundred  and  seventy-five  pages. 


20  BLANCHARD  &  LEA'S  PUBLICATIONS.—  (Z?Me<m*  of  Females.} 


NEW  AIVD  IMPROVED  EDITION-CLately  Isaued.) 

THE  DISEASES~OF  FEMALES, 
INCLUDING  THOSE  OF  PREGNANCY  AND  CHILDBED. 

BY  FLEETWOOD  CHURCHILL,  M.  V.,  M.  R.  I.  A., 

Author  of  "Theory  and  Practice  of  Midwifery,"  "Diseases  of  Females,"  &c. 

A  New  American  Edition  (The  Fifth),   Revised  by  the  Author. 

WITH  THE  NOTES  OF  ROBERT  M.  HUSTON,  M.  D. 
In  one  large  and  handsome  octavo  volume  of  632  pages,  with  wood-cuts. 

To  indulge  in  panegyric,  when  announcing  the  fifth  edition  of  any  acknowledged  medical  authority,  were 
to  attempt  to  "gild  refined  gold."  The  work  announced  above,  has  too  long  heen  honored  with  the  term 
'•  classical"  to  leave  any  doubt  as  lo  its  true  worth,  and  we,  content  ourselves  with  remarking,  that  the  author 
has  carefully  retained  the  notes  of  Dr.  Huston,  who  edited  the  former  American  edition,  thus  really  enhanc- 
ing the  value  of  the  work,  and  paying  a  well  merited  compliment.  All  who  wish  to  be  u  posted  up"  on  all 
that  relates  to  the  diseases  peculiar  to  the  wife,  the  mother,  or  the  maid,  will  hasten  to  secure  a  copy  of  this 
most  admirable  treatise.  —  The  Okio  Medical  and  Surgical  Journal. 

We  know  of  no  author  who  deserves  that  approbation,  on  "  the  diseases  of  females,"  to  the  same  extent 
that  Dr.  Churchill  does.  His,  indeed,  is  the  only  thorough  treatise  we  know  of  on  the  subject,  and  it  may  be 
commended  to  practitioners  and  students  as  a  masterpiece  in  its  particular  department.  The  former  editions 
of  this  work  have  been  commended  strongly  in  this  journal,  and  they  have  won  their  way  to  "an  extended, 
and  a  well  deserved  popularity.  This  fifth  edition,  before  us,  is  well  calculated  to  maintain  Dr.  Churchill's 
hi?h  reputation.  It  was  revised  and  enlarged  by  the  author,  for  his  American  pnblishers,  and  it  seems  to  usy 
that  there  is  scarcely  any  species  of  desirable  information  on  its  subjects,  that  may  not  be  found  in  this  work. 
—  The  Western  Journal  of  Medicine  and  Surgery. 

We  are  gratified  to  announce  a  new  and  revised  edition  of  Dr.  Churchill's  valuable  work  on  the  diseases 
of  females.  We  have  ever  regarded  it  as  one  of  the  very  best  works  on  the  subjects  embraced  within  ita 
scope,  in  the  English  language  ;  and  the  present  edition,  enlarged  and  revised  by  the  author,  renders  it  still 
more  entitled  to  the  confidence  of  the  profession.  The  valuable  notes  of  Prof.  Huston  have  been  retained, 
and  contribute,  in  no  small  degree,  to  enhance  the  value  of  the  work.  It  is  a  source  of  congratulation  that 
the  publishers  have  permitted  the  author  to  be,  in  this  instance,  his  own  editor,  thus  securing  all  the  revision 
which  an  author  alone  is  capable  of  m-aking.  —  The  Western  Lancet. 

As  a  comprehensive  manual  for  students,  or  a  work  of  reference  for  practitioners,  we  only  speak  with 
common  justice  when  we  say  that  it  surpasses  any  other  that  has  ever  issued  on  the  same  subject  from  the 
British  press.—  The  Dublin  Quarterly  Journal. 


Churchill's  Monographs  on  Females — (Just  Issued.) 

ESSAYS  ON  THE  PUERPERAL~FEVER,  AND  OTHER  DISEASES 

PECULIAR    TO    WOMEN. 

SELECTED  FROM  THE  WRITflVGS  OF  BRITISH  AUTHORS  PREVIOUS  TO  THE  CLOSE  OF 
THE  EIGHTEENTH  CENTURY. 

Edited  by  FLEETWOOD  CHURCHILL,  M.  D.,  M.  R.  I.  A., 

Author  of  "Treatise  on  the  Diseases  of  Females,"  &c. 
In  one  neat  octavo  volume,  of  about  four  hundred  and  fifty  pages. 

To  these  papers  Dr.  Churchill  has  appended  notes,  embodying  whatever  information  ha«  been  laid  before 
the  profession  since  their  authors'  time.  He  has  also  prefixed  to  the  essays  on  puerperal  fever,  which  occu- 
py the  larger  portion  of  the  volume,  an  interesting  historical  sketch  of  theprincipal  epidemicsof  that  disease, 
The  whole  forms  a  very  valuable  collection  of  papers  by  professional  writers  of  eminence,  on  some  of  th« 
meet  important  accidents  to  which  the  puerperal  female  is  liable.— American  Journal  of  Medical  Sciences. 


*TfUCH  EWLtAHGED  AJV&  IMPnOVED  EDITION— (Just  Issued.) 

A     PRACTICAL~TREATISE    ON 

INFLAMMATION  OF  THE  UTERUS  AND  ITS  APPENDASES, 

And  on  Ulceration  and  Induration  of  the  Neck  of  the  Uterus. 

BY  HENRY  BENNETT,  M.  D., 

Obstetric  Physician  to  the  Western  Dispensary. 
Second  Edition^  much  enlarg-ed. 

In  one  neat  octavo  volume  of  350  pages,  with  wood-cuts. 

This  edition  is  so  enlarged  as  to  constitute  a  new  work.  It  embraces  the  study  of  inflammation 
in  all  the  uterine  organs,  and  its  influence  in  the  production  of  displacements  and  of  the  reputed 
functional  diseases  of  the  uterus. 

Few  works  iseue  frora  the  medical  press  which  are  at  once  original  and  sound  in  doctrine  ;  but  such,  we 
feel  assured,  is  the  admirable  treatise  now  before  us.  The  important  practical  precepts  which  the  author 
implicates  are  all  rigidly  deduced  from  facts.  .  .  .  Every  page  of  the  book  is  good,  and  eminently  practical. 
So  far  as  we  know  and  believe,  it  is  the  best  work  on  the  subject  on  which  it  treats. — Monthly  Journal  of 
Medical  Science. 

A  TREATISE  ON  THE  DISEASES  OF  FEMALES. 
BY  W.  P.  DEWEES,  M.  D. 

NINTH  EDITION. 
En  one  volume,  octavo.    532  pages,  with  plates. 


BLANCHARD  &  LEA'S  PUBLICATIONS.— (Diseases  of  Children.)  21 


MEIGS   ON  CHILDREN— Just  Issued, 
OBSERVATIONS   ON 

CERTAIN  OF  THE  DISEASES  OF  YOUNG  CHILDREN, 

BY  CHARLES  D.  MEIGS,  M.  D., 

Professor  of  Midwifery  and  of  the  Diseases  of  Women  and  Children  in  the  Jefferson 
Medical  College  of  Philadelphia,  &c.  &c. 

In  one  handsome  octavo  volume  of  214  pages. 

While  this  worfe  is  not  presented  to  the  profession  as  a  systematic  and  complete  treatise  on  In- 
fantile disorders,  the  importance  of  the  subjects  treated  of,  and  the  interest  attaching  to  the  views 
and  opinions  of  the  distinguished  author  must  command  for  it  the  attention  of  all  who  are  called 
upon  to  treat  this  interesting  class  of  diseases. 

It  puts  forth  no  claims  as  a  systematic  work,  but  contains  an  amount  of  valuable  and  useful  matter, 
scarcely  to  be  found  in  the  same  space  in  our  home  literature.  It  can  not  but  prove  an  acceptable  offering 
to  the  profession  at  large. — N.  Y.  Journal  of  Medicine. 

The  work  before  us  is  undoubtedly  a  valuable  addition  to  the  fund  of  information  which  has  already  been 
treasured  «p  on  the  subjects  in  question.  It  is  practical,  and  therefore  eminently  adapted  to  the  general 
practitioner.  Dr.  Meigs'  works  have  the  same  fascination  which  belongs  to  himself.— Medical  Examiner. 

This  is  a  most  excellent  work  on  the  obscure  diseases  of  childhood,  and  will  afford  the  practitioner  and 
student  of  medicine  much  aid  in  their  diagnosis  and  treatment.—  The  Boston  Medical  and  Surgical  Journal. 

We  take  much  pleasure  in  recommending  this  excellent  little  work  to  the  attention  of  medical  practition- 
ers. It  deserves  their  attention,  and  alter  they  commence  its  perusal,  they  will  not  willingly  abandon  it, 
until  they  have  mastered  its  contents.  We  read  the  work  while  suffering  from  a  carbuncle,  and  its  fasci- 
nating pages  often  beguiled  us  into  lorgetfulness  of  agonizing  pain.  May  it  teach  others  to  relieve  the  afflic- 
tions of  the  young. —  The  Western  Journal  of  Medicine  and  Surgery. 

All  of  which  topics  are  treated  with  Dr.  Meigs'  acknowledged  ability  and  original  diction.  The  work  is 
neither  a  systematic  nor  a  complete  treatise  upon  the  diseases  of  children,  but  a  fragment  which  may  be  con- 
sulted with  much  advantage. — Southern  Medical  and  Surgical  Journal. 


NEW  WORK  BY  DR.  CHURCHILL. 
ON    THE 

DISEASES  OF  INFANTS  AND   CHILDREN. 

BY  FLEETWOOD  CHURCHILL,  M.  D.,  M.  R.  I.  A., 

Author  of  "Theory  and  Practice  of  Midwifery,"  "Diseases  of  Females,"  &c. 
In  one  large  and  handsome  octavo  volume  of  over  600  pages. 

From  Dr.  Churchill's  known  ability  and  industry,  we  were  led  to  form  high  expectations  of  this  work;  nor 
Were  we  deceived.  Its  learned  author  seems  to  have  set  no  bounds  to  his  researches  in  collecting  informa- 
tion which,  with  his  usual  systematic  address,  he  has  disposed  of  in  the  most  clear  and  concise  manner,  so 
as  to  lay  before  the  reader  every  opinion  of  importance  bearing  upon  the  subject  under  consideration. 

We  regard  this  volume  as  possessing  more  claims  to  completeness  than  any  other  of  the  kind  with  which 
we  are  acquainted.  Most  cordially  and  earnestly,  therefore,  do  we  commend  it  to  our  professional  brethren, 
and  we  feel  assured  that  the  stamp  of  their  approbation  will  in  due  time  be  impressed  upon  it. 

After  an  attentive  perusal  of  its  contents,  we  hesitate  not  to  say,  that  it  is  one  of  the  most  comprehensive 
ever  written  upon  the  diseases  of  children,  and  that,  for  copiousness  of  reference,  extentof  research,  and  per- 
spicuity of  detail,  it  is  scarcely  to  be  equalled,  and  not  to  be  excelled  in  any  language. — Dublin  Quarterly 
Journal. 

The  present  volume  will  sustain  the  reputation  acquired  by  the  author  from  his  previous  works.  The 
reader  will  find  in  it  full  and  judicious  directions  for  the  management  of  infants  at  birth,  and  a  compendious, 
but  clear,  account  of  the  diseases  to  which  children  are  liable,  and  the  most  successful  mode  of  treating  them. 
We  must  not  close  this  notice  without  calling  attention  to  the  author's  style,  which  is  perspicuous  and 
polished  to  a  degree,  we  regret  to  say,  not  generally  characteristic  of  medical  works.  We  recommend  the 
•work  of  Dr.  Churchill  most  cordially,  both  to  students  and  practitioners,  as  a  valuable  and  reliable  guide  in 
the  treatment  of  the  diseases  of  children. — Am.  Journ.  of  the  Med.  Sciences. 

After  this  meagre,  and  we  know,  very  imperfect  notice,  of  Dr.  Churchill's  work,  we  shall  conclude  by 
saying  that  it  is  one  that  cannot  fail  from  its  copiousness,  extensive  research,  and  general  accuracy,  to  exalt 
still  higher  the  reputation  of  the  author  in  this  country.  The  American  reader  will  be  particularly  pleased 
to  find  that  Dr.  Churchill  has  done  full  justice  throughout  his  work,  to  the  various  American  authors  on  this 
subject.  The  names  of  Dewees,  Eyerie,  Condie,  and  Stewart,  occur  on  nearly  every  page,  and  these  authors 
are  constantly  referred  to  by  the  author  in  terms  of  the  highest  praise,  and  with  the  most  liberal  courtesy. — 
The  Medical  Examiner. 

We  know  of  no  work  on  this  department  of  Practical  Medicine  which  presents  so  candid  and  unpreju- 
diced a  statement  or  posting  up  of  our  actual  knowledge  as  this.—  N.  Y.  Journal  of  Medicine. 

Its  claims  to  merit,  both  as  a  scientific  and  practical  work,  are  of  the  highest  order.  Whilst  we  would 
not  elevate  it  above  every  other  treatise  on  the  same  subject,  we  certainly  believe  that  very  few  are  equal 
to  it,  ami  none  superior.—  Southern  Med.  and  Surg.  Journal. 


22  BLANCHARD  &  LEA'S  PUBLICATIONS.— (Diseases  of  Children.") 

New  and  Improved  Edition— (Lately  Issued.) 
A  PRACTICAL  TREATISE  ON  THE 

DISEASES    OF    CHILDREN. 

BY  D.  FRANCIS  CONDIE,  M.  D., 

Fellow  of  the  College  of  Physicians,  &c.  &c. 
Third  edition,  revised  and  augmented.     In  one  large  volume,  8vo.,  of  over  700  pages. 

In  the  preparation  of  a  third  edition  of  the  present  treatise,  every  portion  of  it  has  been  subjected 
to  a  careful  revision.  A  new  chapter  has  been  added  on  Epidemic  Meningitis,  a  disease  which, 
although  not  confined  to  children,  occurs  far  more  frequently  in  them,  than  in  adults.  In  the  other 
chapters  of  the  work,  all  the  more  important  facts  that  have  been  developed  since  the  appearance 
of  the  last  edition,  in  reference  to  the  nature,  diagnosis,  and  treatment  of  the  several  diseases  of 
which  they  treat,  have  been  incorporated.  The  great  object  of  the  author  has  been  to  present,  in 
each  succeeding  edition,  as  full  and  connected  a  view  as  possible  of  the  actual  state  of  the  pa- 
thology and  therapeutics  of  those  affections  which  most  usually  occur  between  birth  and  puberty. 

To  the  present  edition  there  is  appended  a  list  of  the  several  works  and  essays  quoted  or  referred 
to  in  the  body  of  the  work,  or  which  have  been  consulted  in  its  preparation  or  revision. 

Every  important  fact  that  has  been  verified  or  developed  since  the  publication  of  the  previous  edition, 
either  in  relation  to  the  nature,  diagnosis,  or  treatment  of  the  diseases  of  children,  have  been  arranged  and 
incorporated  into  the  body  of  the  work  ;  thus  posting  up  to  date,  to  use  a  counting-house  phrase,  all  the 
valuable  facts  and  useful  information  on  the  subject.  To  the  American  practitioner,  Dr.  Condie's  remarks 
on  the  diseases  of  children  will  be  invaluable,  and  we  accordingly  advise  those  who  have  failed  to  read  this 
work  to  procure  a  copy,  and  make  themselves  familiar  with  its  sound  principles. — The  New  Orleans  Medical 
and  Surgical  Journal. 

We  feel  persuaded  that  the  American  Medical  profession  will  soon  regard  it,  not  only  as  a  very  good,  but 
as  the  VERY  BEST  "  Practical  Treatise  on  the  Diseases  of  Children." — American  Medical  Journal. 

We  pronounced  the  first  edition  to  be  the  best  work  on  the  Diseases  of  Children  in  the  English  language, 
and,  notwithstanding  all  that  has  been  published,  we  still  regard  it  in  that  light. — Medical  Examiner. 
From  Professor  Wm.  P.  Johnston,  Washington,  D.  C. 

I  make  use  of  it  as  a  text-book,  and  place  it  invariably  in  the  hands  of  my  private  pupils. 
From  Professor  D.  Humphreys  Storer,  of  Boston. 

I  consider  it  to  be  the  best  work  on  the  Diseases  of  Children  we  have  access  to,  and  as  such  recommend  it 
to  all  who  ever  refer  to  the  subject. 

From  Professor  M.  M.  Fallen,  of  St  Louis. 

I  consider  it  the  best  treatise  on  the  Diseases  of  Children  that  we  possess,  and  as  such  have  been  in  the 
habit  of  recommending  it  to  my  classes. 

Dr.  Condie's  scholarship,  acumen,  industry,  and  practical  sense  are  manifested  in  this,  as  in  all  his  nu- 
merous contributions  to  science. —  Dr.  Holmes^  Report  to  the  American  Medical  Association. 

Taken  as  a  whole,  in  our  judgment.  Dr.  Condie's  Treatise  is  the  one  from  the  perusal  of  which  the  practi- 
tioner in  this  country  will  rise  with  the  greatest  satisfaction.—  Western  Journal  of  Medicine  and  Surgery. 

One  of  the  best  works  upon  the  Diseases  of  Children  in  the  English  language.—  Western  Lancet. 

We  feel  assured  from  actual  experience  that  no  physician's  library  can  be  complete  without  a  copy  ofthis 
work.— JV.  Y.  Journal  of  Medicine 

Perhaps  the  most  full  and  complete  work  now  before  the  profession  of  the  United  States;  indeed,  we  may 
say  in  the  English  language.  It  is  vastly  superior  to  most  of  its  predecessors. — Transylvania  Med  Journal. 

A  veritable  paediatric  encyclopaedia,  and  an  honor  to  American  medical  literature.—  Ohio  Medical  and  Sur- 
gical Journal. 


WEST  OJT  DISEASES  OF  CHILDREjr—  (JTow  Complete.} 

LECTURES  ON  THE 

DISEASES  OF  INFANCY  AND  CHILDHOOD. 

BY  CHARLES  WEST,  M.  D., 

Senior  Physician  to  the  Royal  Infirmary  for  Children,  &c.  &c. 

In  one  volume,  octavo. 

Every  portion  of  these  lectures  is  marked  by  a  general  accuracy  of  description,  and  by  the  soundness  of 
the  views  set  forth  in  relation  to  the  pathology  and  therapeutics  of  the  several  maladies  treated  of.  The  lec- 
tures on  the  diseases  of  the  respiratory  apparatus,  about  one-third  of  the  whole  number,  are  particularly 
excellent,  forming  one  of  the  fullest  and  most  able  accounts  of  these  affections,  as  they  present  themselves 
during  infancy  and  childhood,  in  the  English  language.  The  history  of  the  several  forms  of  phthisis  during 
these  periods  of  existence,  with  their  management,  will  be  read  by  all  with  deep  interest. —  The  American 
Journal  of  the  Medical  Sciences. 

jt  The  Lectures  of  Dr.  West,  originally  published  in  the  London  Medical  Gazette,  form  a  most  valuable 
addition  to  this  branch  of  practical  medicine.  For  many  years  physician  to  the  Children's  Infirmary,  his 
opportunities  for  observing  their  diseases  have  been  most  extensive,  no  less  than  14,000  children  having  been 
brought  under  his  notice  during  the  past  nine  years.  These  have  evidently  been  studied  with  great  care, 
and  the  result  has  been  the  production  of  the  very  best  work  in  our  language,  so  far  as  it  goes,  on  the  dis- 
eases of  this  class  of  our  patients.  The  symptomatology  and  pathology  of  their  diseases  are  especially 
exhibited  most  clearly;  and  we  are  convinced  that  no  one  can  read  with  care  these  lectures  without  deriv- 
ing from  them  instruction  of  the  most  important  kind.—  Charleston  Med.  Journal. 


A    TREATISE 

ON  THE  PHYSICAL  AND  MEDICAL  TREATMENT  OP  CHILDREN. 

BY  W.  P.  DEWEES,  M.  D. 

Ninth  edition.    In  one  volume,  octavo.    548  pages. 


BLANCHARD    &   LEA'S   PUBLICATIONS.— (Obstetrics.)  23 

Ji  JYJEW  WOHK—  (Lately  Issued.) 

OBSTETRICS: 

THE    SCIENCE    AND    THE    ART. 

BY  CHARLES  D.  MEIGS,  M.D., 

Professor  of  Midwifery  and  the  Diseases  of  Women  and  Children  in  the  Jefferson  Medical  College, 

Philadelphia,  &c.  &c. 

With  One  Hundred  and  Twenty  Illustrations. 
In  one  beautifully  printed  octavo  volume,  of  six  hundred  and  eighty  large  pages. 

As  an  elementary  treatise — concise,  but,  withal,  clear  and  comprehensive— we  know  of  no  one  better 
adapted  for  the  use  of  the  student;  while  the  young  practitioner  will  find  in  it  a  body  of  sound  doctrine, 
and  a  series  of  excellent  practical  directions,  adapted  to  all  the  conditions  of  the  various  forms  of  labor 
and  their  results,  which  he  will  be  induced,  we  are  persuaded,  again  and  again  to  consult,  and  always  with 
profit. 

It  has  seldom  been  our  lot  to  peruse  a  work  upon  the  subject,  from  which  we  have  received  greater  satis- 
faction, and  which  we  believe  to  be  better  calculated  to  communicate  to  the  student  correct  and  definite 
views  upon  the  several  topics  embraced  within  the  scope  of  its  teachings. — American  Journal  of  the  Medical 
Sciences. 

\V<>  Jire  acquainted  with  no  work  on  midwifery  of  greater  practical  value.— Boston  Medical  and  Surgical 
Journal. 

Worthy  the  reputation  of  its  distinguished  author. — Medical  Examiner. 

We  most  sincerely  recommend  it.  both  to  the  student  and  practitioner,  as  a  more  complete  and  valuable 
work  on  the  Science  and  Art  of  Midwifery,  than  any  of  the  numerous  reprints  and  American  editions  of 
European  works  on  the  same  subject.— AT.  Y.  Annalist. 

We  have,  therefore,  great  satisfaction  in  bringing  under  our  reader's  notice  the  matured  views  of  the 
highest  American  authority  in  the  department  to  which  he  has  devoted  his  life  and  talents. — London  Medical 
Gazelle. 

An  author  of  established  merit,  a  professor  of  Midwifery,  and  a  practitioner  of  high  reputation  and  immense 
experience— we  may  assuredly  regard  his  work  now  before  us  as  representing  the  most  advanced  state  of 
obstetric  science  in  America  up  to  the  time  at  which  he  writes.  We  consider  Dr.  Meigs'  book  as  a  valuable 
acquisition  to  obstetric  literature,  and  one  that  will  very  much  assist  the  practitioner  under  many  circum- 
stances of  doubt  and  perplexity. —  The  Dublin  Quarterly  Journal. 

These  various  heads  are  subdivided  so  well,  so  lucidly  explained,  that  a  good  memory  is  all  that  is  neces- 
sary in  order  to  put  the  reader  in  possession  of  a  thorough  knowledge  of  this  important  subject.  Dr.  Meigs 
has  conferred  a  great  benefit  on  the  profession  in  publishing  this  excellent  work. — St.  Louis  Medical  and 
Surgical  Journal. 

No  reader  will  lay  the  volume  down  without  admiration  for  the  learning  and  talents  of  the  author.  An  abler 
volume,  on  the  whole,  we  do  not  hope  soon  to  see. —  Western  Journal  of  Medicine  and  Surgery. 

A  safe  and  efficient  guide  to  the  delicate  and  ofttimes  difficult  duties  which  devolve  upon  the  obstetrician. — 
Ohio  Medical  and  Surgical  Journal. 

One  of  the  very  best  treatises  on  this  subject,  and  worthy  of  being  placed  in  the  library  of  every  American 
physician. — Northwestern  Medical  and  Surgical  Journal. 

He  has  an  earnest  way  with  him  when  speaking  of  the  most  elementary  subjects  which  fixes  the  attention 
and  adds  much  value  to  the  work  as  a  text- book  for  students. — British  and  Foreign  Medico- Chirurgical 
Review. 

TYLER  SMITH   OX  PARTURITION— (Lately  Issued.) 

ON    PARTURITION, 

AND  THE  PRINCIPLES  AND  PRACTICE  OF  OBSTETRICS. 

BY  W.  TYLER  SMITH,  M.  D., 

Lecturer  on  Obstetrics  in  the  Hunterian  School  of  Medicine,  &c.  &c. 
In  one  large  duodecimo  volume,  of  400  pages. 

The  work  will  recommend  itself  by  its  intrinsic  merit  to  every  member  of  the  profession.— Lancet. 

\Ve  can  imagine  the  pleasure  with  which  William  Hunter  or  Deriman  would  have  welcomed  the  present 
work;  certainly  the  most  valuable  contribution  to  obstetrics  that  has  been  made  since  their  own  day.  For 
ourselves,  we  consider  its  appearance  as  the  dawn  of  a  new  era  in  this  department  of  medicine.  We  do 
most  cordially  recommend  the  work  as  one  absolutely  necessary  to  be  studied  by  every  accoucheur.  It  will, 
we  may  add,  prove  equally  interesting  and  instructive  to  the  student,  the  general  practitioner,  and  pure  ob- 
stetrician. It  was  a  bold  undertaking  to  reclaim  parturition  for  Reflex  Physiology,  and  it  has  been  well  per- 
formed.— London  Journal  of  Medicine. 

LEE'S   CLINICAL   MIDWIFERY- (Lately  Issued.) 

CLINICAL    MIDWIFERY, 

COMPRISING   THE    HISTORIES    OF  FIVE   HUNDRED  AND  FORTY-FIVE  CASES  OF  DIFFI- 
CULT, PRETERNATURAL,  AND  COMPLICATED  LABOR,  WITH  COMMENTARIES. 

BY  ROBERT  LEE;  M.  D.,  F.  R.  S.,  &c. 
From  the  2d  London  Edition. 

In  one  royal  12mo.  volume,  extra  cloth,  of  238  pages. 

More  instructive  to  the  juvenile  practitioner  than  a  score  of  systematic  works. — Lancet. 

An  invaluable  record  for  the  practitioner. — N.  Y.  Annalist. 

A  storehouse  of  valuable  facts  and  precedents.— American  Journal  of  the  Medical  Sciences. 


24  BLANCHARD  &  LEA'S  PUBLICATIONS.— (Obstetrics.-) 

CHURCHILL'S  MIDWIFERY,  BY  CONDIE,  NEW  AND  IMPROVED  EDITION-(Now  Ready.) 

ON~THE 

THEORY  AND  PRACTICE  OF  MIDWIFERY. 

BY  FLEETWOOD  CHURCHILL,  M.  D.,  &c. 

A  NEW  AMERICAN  FROM  THE  LAST  AND  IMPROVED  ENGLISH  EDITION, 

EDITED,  WITH  NOTES  AND  ADDITIONS, 

BY  D.  FRANCIS   CONDIE,  M.  D., 

Author  of  a  "  Practical  Treatise  on  the  Diseases  of  Children,"  &c. 

WITH  ONE  HUNDRED   AND   THIRTY-NINE    ILLUSTRATIONS. 
In  one  very  handsome  octavo  volume. 

In  the  preparation  of  the  last  English  edition,  from  which  this  is  printed,  the  author  has  spared 
no  pains,  with  the  desire  of  bringing  it  thoroughly  up  to  the  present  state  of  obstetric  science. 
The  labors  of  the  editor  have  thus  been  light,  but  he  has  endeavored  to  supply  whatever  he  has 
thought  necessary  to  the  work,  either  as  respects  obstetrical  practice  in  this  country,  or  its 
progress  in  Europe  since  the  appearance  of  Dr.  Churchill's  last  edition.  Most  of  the  notes  of  the 
former  editor,  Dr.  Huston,  have  been  retained  by  him,  where  they  have  not  been  embodied  by  the 
author  in  his  text.  The  present  edition  of  the  favorite  text-book  is  therefore  presented  to  the  pro- 
fession in  the  full  confidence  of  its  meriting  a  continuance  of  the  great  reputation  which  it  has 
acquired  as  a  work  equally  well  fitted  for  the  student  and  practitioner. 

To  bestow  praise  on  a  book  that  has  received  such  marked  approbation  would  be  superfluous.  We  need 
only  say,  therefore,  that  if  the  first  edition  was  thought  worthy  of  a  favorable  reception  by  the  medical  pub- 
lic, we  can  confidently  affirm  that  this  will  be  found  much  more  so.  The  lecturer,  the  practitioner,  and  the 
student,  may  all  have  recourse  to  its  pages,  and  derive  from  their  perusal  much  interest  and  instruction  in 
everything  relating  to  theoretical  and  practical  midwifery. — Dublin  Quarterly  Journal  of  Medical  Science. 

A  work  of  very  great  merit,  and  such  as  we  can  confidently  recommend  to  the  study  of  every  obstetric 
practitioner.— London  Medical  Gazette. 

This  is  certainly  the  most  perfect  system  extant.  It  is  the  best  adapted  for  the  purposes  of  a  text-book,  and 
that  which  he  whose  necessities  confine  him  to  one  book,  should  select  in  preference  to  all  others. — Southern 
Medical  and  Surgical  Journal. 

The  most  popular  work  on  Midwifery  ever  issued  from  the  American  press  — Charleston  Medical  Journal. 

Certainly,  in  our  opinion,  the  very  best  work  on  the  subject  which  exists. — N.  Y.  Annalist. 

Were  we  reduced  to  the  necessity  of  havingbut  one  work  on  Midwifery,  and  permitted  to  choose,  we  would 
unhesitatingly  take  Churchill. —  Western  Medical  and  Surgical  Journal. 

It  is  impossible  to  conceive  a  more  useful  and  elegant  Manual  than  Dr.  Churchill's  Practice  of  Midwifery. 
—  Provincial  Medical  Journal. 

No  work  holds  a  higher  position,  or  is  more  deserving  of  being  placed  in  thehandsof  the  tyro,  the  advanced 
student,  or  the  practitioner. — Medical  Examiner. 


EDITIOJV  OF  RAJtlSBOTHJiJfl  OJV  PARTURITIOJV-^oto  Heady,  1851.) 

THE  PRINCIPLES~AND  PRACTICE  OP 

OBSTETRIC   MEDICINE  AND  SURGERY, 

In  reference  to  the  Process  of  Parturition, 
BY   FRANCIS    H.    KAMSBOTHAM,    M.  D., 

Physician  to  the  Royal  Maternity  Charity,  &c.  &c. 
SIXTH  AMERICAN  FROM  THE  LAST  LONDON  EDITION. 

Illustrated  with  One  Hundred  and  Forty-eight  Figures  on  Fifty-five  Lithographic  Plates. 
In  one  large  and  handsomely  printed  volume,  imperial  octavo,  with  520  pages. 

In  this  edition  the  plates  have  all  been  redrawn,  and  the  text  carefully  read  and  corrected.  It 
is  therefore  presented  as  in  every  way  worthy  the  favor  with  which  it  has  so  long  been  received. 

From  Professor  Hodge,  of  the  University  of  Pennsylvania. 

To  the  American  public,  it  is  most  valuable,  from  its  intrinsic  undoubted  excellence,  and  as  being  the  best 
authorized  exponent  of  British  Midwifery.  Its  circulation  will,  i  trust,  be  extensive  throughout  our  country. 

We  recommend  the  student,  who  desires  to  master  this  difficult  subject  with  the  least  possible  trouble,  to 
possess  himself  at  once  of  a  copy  of  this  work.— American  Journal  of  the  Medical  Sciences. 

It  stands  at  the  head  of  the  long  list  of  excellent  obstetric  works  published  in  the  last  few  years  in  Great 
Britain,  Ireland,  and  the  Continent  of  Europe.  We  consider  this  book  indispensable  to  the  library  of  every 
physician  engaged  in  the  practice  of  Midwifery. — Southern  Medical  and  Surgical  Journal. 

When  the  whole  profession  is  thus  unanimous  in  placing  such  a  work  in  the  very  first  rank  as  regards  the 
extent  and  correctness  of  all  the  details  of  the  theory  and  practice  of  so  important  a  branch  of  learning,  our 
commendation  or  condemnation  would  be  of  little  consequence;  but,  regarding  it  as  the  most  useful  of  all  works 
of  the  kind,  we  think  it  but  an  act  of  justice  to  urge  its  claims  upon  the  profession. — N.  0.  Med.  Journal. 


DEWEES'S     MIDWIFERY. 

A  COMPREHENSIVE  SYSTEM  OP  MIDWIFERY, 

ILLUSTRATED  BY  OCCASIONAL  CASES  AND  MANY  ENGRAVINGS. 

BY  WILLIAM  P.  DEWBES,  M,  D. 
Tenth  Edition,  with  the  Author's  last  Improvements  and  Corrections.    In  one  octavo  volume,  of  600  pages. 


BLANCHARD  &  LEA'S  PUBLICATIONS.—  (Materia  Medica  and  Therapeutics.)    25 


NEW  EDITION,  GREATLY  IMPROVED  AND  ENLARGED—  (Nearly  Ready.) 
THE    ELlaiWCEIffTS 

OF  MATERIA  MEDICA  AND  THERAPEUTICS, 

COMPREHENDING  THE  NATURAL    HISTORY,  PREPARATION,  PROPERTIES,  COMPOSITION, 

EFFECTS,  AND  USES  OF  MEDICINES, 

BY  JONATHAN  PEREIRA,  M.  D.;  F.  R.  S.  AND  L.  S. 

Third  American  from  the  Third  and  Enlarged  London  Edition. 

WITH   ADDITIONAL    NOTES    AND    OBSERVATIONS    BY    THE   AUTHOR. 

EDITED  BY  JOSEPH  CARSON,  M.  D., 

Professor  of  Materia  Medica  and  Pharmacy  in  the  University  of  Pennsylvania. 
In  two  very  large  volumes,  on  small  type,  with  about  four  hundred  illustrations. 

The  third  London  edition  of  this  great  work  has  been  thoroughly  revised  and  greatly  enlarged 
by  the  author,  who  has  spared  no  pains  to  render  it  complete  in  every  part,  by  the  addition  of  a 
very  large  amount  of  matter  and  the  introduction  of  many  new  illustrations.  The  present  American 
edition,  however,  in  addition  to  this,  will  not  only  enjoy  the  advantages  of  a  careful  and  accurate 
superintendence  by  the  editor,  but  will  also  embody  the  additions  suggested  by  a  further  revision 
by  the  author,  expressly  for  this  country,  embracing  the  most  recent  discoveries,  and  the  results 
of  several  pharmacopoeias  which  have  appeared  since  the  publication  of  part  of  the  London  edi- 
tion. The  notes  of  the  American  editor  will  be  prepared  with  reference  to  the  new  edition  of  the 
United  States  Pharmacopoeia,  and  will  contain  such  matter  generally  as  may  be  required  to  adapt  it 
fully  to  the  wants  of  the  American  student  and  practitioner,  as  well  as  such  recent  investigations 
and  discoveries  as  may  have  escaped  the  attention  of  the  author.  The  profession  may  therefore 
rely  on  being  able  to  procure  a  work  which  will  not  only  maintain  but  increase  its  right  to  the  ap- 
pellation of 

AN  ENCYCLOPAEDIA  OF  MATERIA  MEDICA  AND  THERAPEUTICS. 

We  shall  only  remark  that  every  article  bears  witness  to  the  industry  and  indefatigable  research  of  the 
author.  Instead  of  being  merely  the  elements  of  materia  medica,  it  constitutes  a  complete  encyclopaedia  of 
thi«  importiint  subject.  The  student  of  physiology,  pathology,  chemistry,  botany,  and  natural  history,  will 
mid  herein  the  most  recent  facts  and  discoveries  in  his  favorite  branch  of  study,  and  the  medical  practitioner 
will  have  in  this  work  a  safe  guide  for  the  administration  and  employment  of  medicines.—  London  Medical 
Gazette. 

The  present  edition  (the  third)  is  very  much  enlarged  and  improved,  and  includes  the  latest  discoveries 
and  views  respecting  medicines  and  their  properties.  We  believe  that  this  work  has  no  equal  in  value  as 
a  book  of  reference,  or  of  general  information  on  materia  medica.—  The  Lancet. 


ROYL,E'S  MATERIA  MEDICA. 

MATERIA  MEDICA  AND  THERAPEUTICS; 

INCLUDING   THE 

Preparations  of  the  Pharmacopoeias  of  London,  Edinburgh,  Dublin,  and  of  the  United  States, 

WITH  MANY  NEW  MEDICINES. 

BY  J.  FORBES  ROYLE,  M.  D.,  F.  R.  S., 

Professor  of  Materia  Medica  and  Therapeutics,  King's  College,  London,  &c.  &c. 

EDITED  BY  JOSEPH  CARSON,  M.  D., 
Professor  of  Materia  Medica  and  Pharmacy  in  the  University  of  Pennsylvania. 

WITH  NINETY-EIGHT  ILLUSTRATIONS. 
In  one  large  octavo  volume,  of  about  seven  hundred  pages. 

Beiugone  of  the  most  beautiful  Medical  works  published  in  this  country. 
This  work  is,  indeed,  a  most  valuable  one,  and  will  fill  up  an  important  vacancy  that  existed  between  Dr. 
Pereira's?  most  learned  and  complete  system  of  Materia  Medica,  and  the  class  of  productions  on  the  other  ex- 
treme,  which  are  necessarily  imperfect  from  their  small  extent.— British  and  Foreign  Medical  Review. 

POCKET    DISPENSATORY    AND    FORMULARY. 

A  DISPENSATORY  AND  THERAPEUTICAL  REMEMBRANCER.  Comprising  the  entire  lists 
of  Materia  Medica,  with  every  Practical  Formula  contained  in  the  three  British  Pharmacopeias. 
With  relative  Tables  subjoined,  illustrating  by  upwards  of  six  hundred  and  sixty  examples,  the 
Extemporaneous  Forms  and  Combinations  suitable  for  the  different  Medicines.  By  JOHN 
MA.YNE,  M.  D.,  L.  R.  C.  S.,  EDIN.,  &c.  &c.  Edited,  with  the  addition  of  the  formulae  of  the 
United  States  Pharmacopoeia,  by  R.  EGLESFELD  GRIFFITH,  M.  D.  In  one  12mo.  volume, 
of  over  three  hundred  large  pages. 
The  neat  typography,  convenient  size,  and  low  price  of  this  volume,  recommend  it  especially  to 

physicians,  apothecaries,  and  students  in  want  of  a  pocket  manual. 

THE    THREE    KINDS   OF    COD-LIVER    OIL, 

Comparatively  considered,  with  their  Chemical  and  Therapeutic  Properties,  by  L.  J.  DE  JONGH, 
M.  D.  Translated,  with  an  Appendix  and  Cases,  by  EDWARD  CAREY,  M.  D.  To  which  is 
added  an  article  on  the  subject  from  "  Dunglison  on  New  Remedies."  In  one  small  12mo. 
volume,  extra  cloth. 


26 


BLANCHARD  &  LEA'S  PUBLICATIONS.—  (Materia  Medico, 


NEW  UNIVERSAL  FORMULARY.— (Just  Issued.) 

A  UNIVERSAL    FORMULARY*, 

CONTAINING   THE 

METHODS  OF   PREPARING    AND  ADMINISTERING 

OFFICINAL  AND  OTHER  MEDICINES, 

THE  WHOLE  ADAPTED  TO  PHYSICIANS  AND  PHARMACEUTISTS 
BY  R.  EGLESFELJ)  GRIFFITH,  M.  D., 

Author  of  "American  Medical  Botany,"  &c. 

In  one  large  octavo  volume  of568  pages,  double  columns. 

In  this  work  will  be  found  not  only  a  very  complete  collection  of  formulae  and  pharmaceutic 
processes,  collected  with  great  care  from  the  best  modern  authorities  of  all  countries,  but  also  a 
vast  amount  of  important  information  on  all  collateral  subjects.  To  insure  the  accuracy  so  neces- 
sary to  a  work  of  this  nature,  the  sheets  have  been  carefully  revised  by  Dr.  Robert  Bridges,  while 
Mr.  William  Procter,  Jr.,  has  contributed  numerous  valuable  formula?,  and  useful  suggestions. 

The  want  of  a  work  like  the  present  has  long  been  felt  in  this  country,  where  the  physician  and 
apothecary  have  hitherto  had  access  to  no  complete  collection  of  formulas,  gathered  from  the 
pharmacopoeias  and  therapeutists  of  all  nations.  Not  only  has  this  desideratum  been  thoroughly 
accomplished  in  this  volume,  but  it  will  also  be  found  to  contain  a  very  large  number  of  recipes  for 
empirical  preparations,  valuable  to  the  apothecary  and  manufacturing  chemist,  the  greater  part  of 
which  have  hitherto  not  been  accessible  in  this  country.  It  is  farther  enriched  with  accurate  ta- 
bles of  the  weights  and  measures  of  Europe  ;  a  vocabulary  of  the  abbreviations  and  Latin  terms 
used  in  Pharmacy;  rules  for  the  administration  of  medicines  ;  directions  for  officinal  preparations  ; 
remarks  on  poisons  and  their  antidotes ;  with  various  tables  of  much  practical  utility.  To  facili- 
tate reference  to  the  whole,  extended  indices  have  been  added,  giving  to  the  work  the  advantages 
of  both  alphabetical  and  systematic  arrangement. 

To  show  the  variety  and  importance  of  the  subjects  treated  of,  the  publishers  subjoin  a  very 
condensed 

SUMMARY  OF  THE  CONTENTS,  IN  ADDITION  TO  THE  FORMULARY  PROPER, 
WHICH  EXTENDS  TO  BETWEEN  THREE  AND  FOUR  HUNDRED  LARGE  DOUBLE- 
COLUMNED  PAGES. 


PREFACE. 
INTRODUCTION. 

WEIGHTS  AND  MEASURES. 

Weights  of  the  United  States  and  Great  Britain.— 
Foreign  Weights.— Measures. 
SPECIFIC  GRAVITY. 

TEMPERATURES  FOR  CERTAIN  PHARMACEUTICAL  OPE- 
RATIONS. 

HYDROMETHICAL  EQUIVALENTS. 
SPECIFIC  GRAVITIES  OF  SOME  OF  THE  PREPARATIONS 

OF  THE  PHARMACOPOEIAS. 
RELATION  BETWEEN  DIFFERENT   THERMOMETRICAL 

SCALES. 
EXPLANATION  OF  PRINCIPAL  ABBREVIATIONS  USED  IN 

FORMULAS. 

VOCABULARY  OF  WORDS  EMPLOYED  IN  PRESCRIPTIONS. 
OBSERVATIONS  ON  THE  MANAGEMENT  OF  THE  SICK  ROOM. 
Ventilation  of  the  Sick  room. — Temperature  of 
the  Sick  room. — Cleanliness  in  the  Sick  room. — 
Quiet  in  the  Sick  room.— Examination  and  Pre- 
servation of  the  Excretions. — Administration  of 
Medicine.— Furniture   of  a  Sick  room.— Proper 
use  of  Utensils  for  Evacuations. 
DOSES  OF  MEDICINES. 

Age.  —  Sex.  —  Temperament.  —  Idiosyncrasy.  — 
Habit.— State  of  the  System. — Time  of  day. — In- 
tervals between  Doses. 
RULES  FOR  ADMINISTRATION  OF  MEDICINES. 
Acids. — Antacids. —  Antilithics  and  Lithontriptics. 
Antispasmodics.— Anthelmintics.—  Cathartics.— 
Enemata. — Suppositories. — Demulcents  or  Emol- 
lients.— Diaphoretics. — Diluents. — Diuretics. — 
Emetics.  —  Ernmenagogues. —  Epispastics. —  Er- 
rhines.  —  Escharotics.  —  Expectorants.  —  Narco- 
tics.— Refrigerants  —  Sedatives.— Sialagogues.— 
Stimulants.— Tonics. 
MANAGEMENT  OF  CONVALESCENCE  AND  RELAPSES. 

From  the  condensed  summary  of  the  contents  thus  given  it  will  be  seen  that  the  completeness 
of  this  work  renders  it  of  much  practical  value  to  all  concerned  in  the  prescribing  or  dispensing 
of  medicines. 


DIETETIC    PREPARATIONS    NOT   INCLUDED 
AMONG  THE  PREVIOUS  PRESCRIPTIONS. 
LIST  OF  INCOMPATIBLES. 

POSOLOGICAL    TABLES    OF  THE  MOST    IM- 
PORTANT MEDICINES.      *•»* 
TABLE     OF      PHARMACEUTICAL     NAMES 
WHICH    DIFFER    IN    THE   U.    STATES 
AND  BRITISH  PHARMACOPOEIAS. 
OFFICINAL     PREPARATIONS     AND    DIREC- 
TIONS. 

INTERNAL  REMEDIES. 

Powders.— Pills  and  Boluses.— Extracts.— Con- 
fections, Conserves,  Electuaries —Pulps.— Sy- 
rups.— Mellites  or  Honeys —Infusions. — Decoc- 
tions.—Tinctures.— Wines.— Vinegars.-Mixtures. 
Medicated  Waters.— Distilled,  Essential,  or  Vola- 
tile Oil.*.— Fixed  Oils  and  Fats.— Alkaloids.— 
Spirits.— Troches  or  Lozenges.— Inhalations. 

EXTERNAL  REMEDIES. 

Baths.— Cold  Bath.— Cool  Bath.— Temperate  Bath. 
—Tepid  Bath  —Warm  Bath.— Hot  Bath.— Shower 
Bath.— Local  Baths —Vapor  Bath.— Warm  Air 
Bath. — Douches.— Medicated  Baths  — Affusion. — 
Sponging. — Fomentations.— Cataplasms,  or  Poul- 
tices.— Lotions,  Liniments,  Embrocations  — Vesi- 
catories,  or  Blisters. —  Issues.  —  Setpns.  —  Oint- 
ments.— Cerates. — Plasters. — Fumigations. 
BLOOD-LETTING. 

General  Blood-Letting.— Venesection.— Arterio- 
tomy. — Topical  Blood-Letting  —  Cupping.-Leech- 
ing. — Scarifications. 

POISONS. 

INDEX  OF  DISEASES  AND  THEIR  REMEDIES. 

INDEX  OF  PHARMACEUTICAL  AND  BOTANI- 
CAL NAMES  * 

GENERAL  INDEX. 


BLANCIIARD  &  LEA'S  PUBLICATIONS—  (Materia  Medica,  ^c.)  27 

GRIFFITH'S  MEDICAL  FORMULARY— (Continued.) 

From  a  vast  number  of  commendatory  notices,  the  publishers  select  a  few. 

A  valuable  acquisition  to  the  medical  practitioner,  and  a  useful  book  of  reference  to  the  apothecary  on 
numerous  occasions — American  Journal  of  Pharmacy. 

Dr.  Griffith's  Formulary  is  worthy  of  recommendation,  not  only  on  account  of  the  care  which  has  been 
bestowed  on  it  by  its  estimable  author,  but  for  its  general  accuracy,  and  the  richness  of  its  details.— Medical 
Examiner. 

Most  cordially  we  recommend  this  Universal  Formulary,  not  forgetting  its  adaptation  to  druggists  and 
apothecaries,  who  would  find  themselves  vastly  improved  by  a  familiar  acquaintance  with  this  every-day 
book  of  medicine. —  The  Boston  Medical  and  Surgical  Journal. 

Pre-eminent  among  the  best  and  most  useful  compilations  of  the  present  day  will  be  found  the  work  before 
us,  which  can  have  been  produced  only  at  a  very  great  cost  of  thought  and  labor.  A  short  description  will 
suffice  to  show  that  we  do  not  put  too  high  an  estimate  on  this  work.  We  are  not  cognizant  of  the  existence 
of  a  parallel  work.  Its  value  will  be  apparent  to  our  readers  from  the  sketch  of  its  contents  above  given. 

We  strongly  recommend  it  to  all  who  are  engaged  either  in  practical  medicine,  or  more  exclusively  with 
its  literature. — London  Medical  Gazette. 

A  very  useful  work,  and  a  most  complete  compendium  on  the  subject  of  materia  medica.  We  know  of  no 
work  in  our  language,  or  any  other,  so  comprehensive  in  all  its  details — London  Lancet. 

The  vast  collection  of  formulae  which  is  offered  by  the  compiler  of  this  volume,  contains  a  large  number 
which  will  be  new  to  English  practitioners,  some  of  them  from  the  novelty  of  their  ingredients,  and  others 
from  the  unaccustomed  mode  in  which  they  are  combined;  and  we  doubt  not  that  several  of  these  might  be 
advantageously  brought  into  use.  The  authority  for  every  formula  is  given,  and  the  list  includes  a  very  nu- 
merous assemblage  of  Continental,  as  well  as  of  British  and  American  writers  of  repute.  It  is,  therefore, 
a  work  to  which  every  practitioner  may  advantageously  resort  for  hints  to  increase  his  stock  of  remedies 
and  of  forms  of  prescription. 

The  other  indices  facilitate  reference  to  every  article  in  the  "Formulary;"  and  they  appear  to  have  been 
drawn  up  with  the  same  care  as  that  which  the  author  has  evidently  bestowed  on  every  part  of  the  work. — 
The  British  and  Foreign  Medico- Chirurgical  Review 

The  work  before  us  is  all  that  it  professes  to  be,  viz.:  "a  compendious  collection  of  formulae  and  pharma- 
ceutic  processes."  It  is  such  a  work  as  was  much  needed,  and  should  be  in  the  hands  of  every  practitioner 
who  is  in  the  habit  of  compounding  medicines. —  Transylvania  Medical  Journal. 

This  seems  to  be  a  very  comprehensive  work,  so  far  as  the  range  of  its  articles  and  combinations  is  con- 
cerned, with  a  commendable  degree  of  brevity  and  condensation  in  their  explanation. 

It  cannot  fail  to  be  a  useful  and  convenient  book  of  reference  to  the  two  classes  of  persons  to  whom  it 
particularly  commends  itself  in  the  title-page. —  The  N.  W.  Medical  and  Surgical  Journal 

It  contains  so  much  information  that  we  very  cheerfully  recommend  it  to  the  profession. —  Charleston  Med. 
Journal. 

To  the  more  advanced  practitioner,  it  affords  occasional  assistance  in  reminding  him  of  combinations  which 
have  stood  the  test  of  time,  and  in  which  experience  has  shown  some  superiority  of  the  associated  means 
over  their  simple  and  unconnected  application.  The  pharmaceutist  will  also  find  advantages  in  its  posses- 
sion, in  the  positions  in  which  he  is  frequently  placed,  either  in  the  demands  of  his  occupation  for  judicious 
formulas,  or  prescription  of  particular  combinations  under  unusual  or  unfamiliar  conventional  names,  in  the 
extraction  of  various  active  principles,  of  vegetable  origin,  and  in  the  production  of  those  chemical  com- 
pounds which,  by  choice  or  necessity,  he  may  deem  advisable  to  prepare  for  himself. 

The  sources  from  which  the  formulae  have  been  derived  are  appended  to  each  formula,  and  are  very  nu- 
merous, embracing  names  of  high  reputation  in  medical  and  pharmaceutical  science,  the  former  giving 
authority  for  the  rational  constitution  of  the  formulae  and  their  applicability  to  particular  states  or  stages  of 
disease,  and  the  latter  the  eligibility  of  the  processes  and  pharmaceutical  preparations  which  they  have 
recommended. —  The  American  Journal  of  the  Medical  Sciences. 

Well  adapted  to  supply  the  actual  wants  of  a  numerous  and  varied  class  of  persons.— N.  Y.  Journal  of 
Medicine. 


CHRISTISON  &  GRIFFITH'S  DISPENSATORY.— (A  New  Work.) 

A  DISPENSATORY, 

OR,  COMMENTARY  ON  THE  PHARMACOPOEIAS  OF  GREAT  BRITAIN  AND  THE  UNITED 

STATES :  COMPRISING  THE  NATURAL  HISTORY,  DESCRIPTION,  CHEMISTRY, 

PHARMACY,  ACTIONS,  USES,  AND  DOSES  OF  THE  ARTICLES  OF 

THE  MATERIA  MEDICA. 

BY  EGBERT  CHRLSTISON,  M.  D.,  Y.  P.  R.  S.  E., 

President  of  the  Royal  College  of  Physicians  of  Edinburgh;  Professor  of  Materia  Medica  in  the  University 

of  Edinburgh,  etc. 

Second  Edition,  Revised  and  Improved, 
WITH  A  SUPPLEMENT  CONTAINING  THE  MOST  IMPORTANT  NEW  REMEDIES. 

WITH    COPIOUS    ADDITIONS, 

AND  TWO  HUNDRED  AND  THIRTEEN  LARGE  WOOD  ENGRAVINGS. 
BY  R.  EGLESFELD  GRIFFITH,  M.  D., 

Author  of  "A  Medical  Botany,"  etc. 
In  one  very  large  and  handsome  octavo  volume,  of  over  one  thousand  closely  printed  pages, 

With  numerous  Wood-cuts, 

BEAUTIFULLY  PRINTED  ON  FINE  WHITE  PAPER. 

Presenting  an  immense  quantity  of  matter  at  an  unusually  low  price. 

It  is  enough  to  say  that  it  appears  to  us  as  perfect  as  a  Dispensatory,  in  the  present  state  of  pharmaceuti- 
cal science,  could  be  made. — The  Western  Journal  of  Medicine  and  Surgery. 


28     BLANCHARD  &  LEA'S  PUBLICATIONS.— (Mater ia  Medica  and  Therapeutics.) 

DUNGLISON'S     THERAPEUTICS. 
WEW  AND  IMPROVED  EDITION.- (Just  Issued.) 

GENERAL  THERAPEUTICS  AND  MATERIA  MEDICA; 

ADAPTED  FOR  A  MEDICAL  TEXT-BOOK, 

BY   ROBLEY  DUNOLISON,  M.  D., 

Professor  of  Institutes  of  Medicine,  &c.,  in  Jefferson  Medical  College ;  Late  Professor  of  Materia  Medica,  &c. 
in  the  Universities  of  Maryland  and  Virginia,  and  in  Jefferson  Medical  College. 

FOURTH   EDITION,    MUCH  IMPROVED. 

With  One  Hundred  and  Eighty-two  Illustrations. 

In  two  large  and  handsomely  printed  octavo  volumes. 

The  present  edition  of  this  standard  work  has  been  subjected  to  a  thorough  revision  both  as  re- 
gards style  and  matter,  and  has  thus  been  rendered  a  more  complete  exponent  than  heretofore  of 
the  existing  state  of  knowledge  on  the  important  subjects  of  which  it  treats.  The  favor  with  which 
the  former  editions  have  everywhere  been  received  seemed  to  demand  that  the  present  should  be 
rendered  still  more  worthy  of  the  patronage  of  the  profession,  and  of  the  medical  student  in  particu- 
lar, for  whose  use  more  especially  it  is  proposed;  while  the  number  of  impressions  through  which 
it  has  passed  has  enabled  the  author  so  to  improve  it  as  to  enable  him  to  present  it  with  some  de- 
gree of  confidence  as  well  adapted  to  the  purposes  for  which  it  is  intended.  In  the  present  edition, 
the  remedial  agents  of  recent  introduction  have  been  inserted  in  their  appropriate  places ;  the 
number  of  illustrations  has  been  greatly  increased,  and  a  copious  index  of  diseases  and  remedies 
has  been  appended,  improvements  which  can  scarcely  fail  to  add  to  the  value  of  the  work  to  the 
therapeutical  inquirer. 

The  publishers,  therefore,  confidently  present  the  work  as  it  now  stands  to  the  notice  of  the 
practitioner  as  a  trustworthy  book  of  reference,  and  to  the  student,  for  whom  it  was  more  especially 
prepared,  as  a  full  and  reliable  text-book  on  General  Therapeutics  and  Materia  Medica. 

Notwithstanding  the  increase  in  size  and  number  of  illustrations,  and  the  improvements  in  the 
mechanical  execution  of  the  work,  its  price  has  not  been  increased. 

In  this  work  of  Dr.  Dunglison,  we  recognize  the  same  untiring  industry  in  the  collection  and  embodying  of 
facts  on  the  several  subjects  of  which  he  treats,  that  has  heretofore  distinguished  him,  and  we  cheerfully 
point  to  these  volumes,  as  two  of  the  most  interesting  that  we  know  of.  In  noticing  the  additions  to  this,  the 
fourth  edition,  there  is  very  little  in  the  periodical  or  annual  literature  of  the  profession,  punlished  in  the  in- 
terval which  has  elapsed  since  the  issue  of  the  first,  that  has  escaped  the  careful  search  of  the  author.  As 
a  book  for  reference,  it  is  invaluable. —  Charleston  Med.  Journal  and  Review. 

It  may  be  said  to  be  the  work  now  upon  the  subjects  upon  which  it  treats.—  Western  Lancet. 

As  a  text  book  for  students,  for  whom  it  is  particularly  designed,  we  know  of  none  superior  to  it.— Si. 
Louis  Medical  and  Surgical  Journal. 

It  purports  to  be  a  new  edition,  but  it  is  rather  a  new  book,  so  greatly  has  it  been  improved  both  in  the 
amount  and  quality  of  the  matter  which  it  contains — N.  O.  Medical  and  Surgical  Journal 

We  bespeak  for  this  edition  from  the  profession  an  increase  of  patronage  over  any  of  its  former  ones,  on 
account  of  its  increased  merit. — N.  Y.  Journal  of  Medicine. 

We  consider  this  work  unequalled.— Boston  Med.  and  Surg.  Journal. 


NEW  AND  MUCH  IMPROVED  EDITION— Brought  up  to  1851.— (Now  Ready.) 

NEW   RE~MEDIES, 

WITH   FORMUL/E   FOR    THEIR    ADMINISTRATION. 
BY  ROBLEY  DUNGLISON,  M.  D., 

PKOFESSOE  OF  THE  INSTITUTES  OF  MEDICINE,  ETC.  IN  THE  JEFFERSON  MEDICAL  COLLEGE  OF  PHILADELPHIA. 

Sixth  Edition,  with  extensive  Additions. 
In  one  very  large  octavo  volume,  of  over  seven  hundred  and  fifty  pages. 

The  fact  that  this  work  has  rapidly  passed  to  a  SIXTH  EDITION  is  sufficient  proof  that  it  has  supplied  a 
desideratum  to  the  profession  in  presenting  them  with  a  clear  and  succinct  account  of  all  new  and  impor- 
tant additions  to  the  materia  medica,  and  novel  applications  of  old  remedial  agents.  In  the  preparation  of 
the  present  edition,  the  author  has  shrunk  from  no  labor  to  render  the  volume  worthy  of  a  continuance  of  the 
favor  with  which  it  has  been  received,  as  is  sufficiently  shown  by  the  increase  of  about  one  hundred  pages 
in  the  size  of  the  work.  The  necessity  of  such  large  additions  arises  from  the  fact  that  the  last  few  years 
have  been  rich  in  valuable  gifts  to  Therapeutics;  and  amongst  these,  ether,  chloroform,  and  other  so  called 
anaesthetics,  are  worthy  of  special  attention.  They  have  been  introduced  since  the  appearance  of  the  last 
edition  of  the  "  NEW  REMEDIKS."  Other  articles  have  been  proposed  for  the  first  time,  and  the  experience  of 
observers  has  added  numerous  interesting  facts  to  our  knowledge  of  the  virtues  of  remedial  agents  pre- 
viously employed. 

The  therapeutical  agents  now  first  admitted  into  this  work,  some  of  which  have  been  newly  introduced 
into  pharmacology,  and  the  old  agents  brought  prominently  forward  with  novel  applications,  and  which  may 
consequently  be  regarded  as  New  Remedies,  are  the  following  :— Adansonia  digitata,  Benzoate  of  Ammonia, 
Valenanate  of  Bismuth,  Sulphate  of  Cadmium,  Chloroform,  Collodion,  Canthandal  Collodion,  Cotyledon  Um- 
bilicus, Sulphuric  Ether,  Strong  Chloric  Ether,  Compound  Ether,  Hura  Braziliensis,  Iberis  Amara,  lodic 
Acid,  Iodide  of  Chloride  of  Mercury,  Powdered  Iron,  Citrate  of  Magnetic  Oxide  of  Iron,  Citrate  of  Iron  and 
Magnesia.  Sulphate  of  Iron  and  Alumina,  Tannate  of  Iron.  Valerianate  of  Iron,  Nitrate  of  Lead,  Lemon 
Juice,  Citrate  of  Magnesia,  Salts  of  Manganese,  Oleum  Cadmum,  Arsenite  of  Quinia,  Hydriodate  of  Iron  and 
Quinia,  Sanicula  Manlandica.  and  Sumbul. 


BLANCHARD   &  LEA'S  PUBLICATIONS.— (Materia  Medica,  fa.)  29 

MOHR,   REDWOOD,    AND   PROCTER'S    PHARMACY.- Just  Issued. 

PRACTICAL~~PHARMACY. 

COMPRISING    THE    ARRANGEMENTS,  APPARATUS,  AND  MANIPULATIONS  OF  THE 
PHARMACEUTICAL    SHOP    AND    LABORATORY. 

BY  FRANCIS  MOHR,  PH.D., 
Assessor  Pharmacise  of  the  Royal  Prussian  College  of  Medicine,  Coblentz; 

AND  THEOPHILUS  REDWOOD, 

Professor  of  Pharmacy  in  the  Pharmaceutical  Society  of  Great  Britain. 
EDITED,   WITH    EXTENSIVE   ADDITIONS,    BY    PROFESSOR    WILLIAM   PROCTER, 

Of  the  Philadelphia  College  of  Pharmacy. 
IB  one  handsomely  printed  octavo  volume,  of  570  pages,  with  over  500  engravings  on  wood. 

To  physicians  in  the  country,  and  those  at  a  distance  from  competent  pharmaceutists,  as  well  as 
to  apothecaries,  this  work  will  be  found  of  great  value,  as  embodying  much  important  information 
which  is  to  be  met  with  in  no  other  American  publication. 

After  a  pretty  thorough  examination,  we  can  recommend  it  as  a  highly  useful  book,  which  should 
be  in  the  hands  of  every  apothecary.  Although  no  instruction  of  this  kind  will  enable  the  beginner  to 
acquire  that  practical  skill  and  readiness  which  experience  only  can  confer,  we  believe  that  this  work  will 
much  facilitate  their  acquisition,  by  indicating  means  for  the  removal  of  difficulties  as  they  occur,  and  sug- 
gesting methods  of  operation  in  conducting  pharmaceutic  processes  which  the  experimenter  would  only 
hit  upon  after  many  unsuccessful  trials;  while  there  are  few  pharmaceutists,  of  however  extensive  expe- 
rience, who  will  not  find  in  it  valuable  hints  that  they  can  turn  to  use  in  conducting  the  affairs  of  the  shop 
and  laboratory.  The  mechanical  execution  of  the  work  is  in  a  style  of  unusual  excellence.  It  contains 
about  five  hundred  and  seventy  large  octavo  pages,  handsomely  printed  on  good  paper,  and  illustrated  by 
over  five  hundred  remarkably  well  executed  wood-cuts  of  chemical  and  pharmaceutical  apparatus.  It 
comprises  the  whole  of  Mohr  and  Redwood's  book,  as  published  in  London,  rearranged  and  classified  by 
;he  American  editor,  who  has  added  much  valuable  new  matter,  which  has  increased  the  size  of  the  book 
more  than  one- fourth,  including  about  one  hundred  additional  wood-cuts.—  The  American  Journ.  of Pharmacy. 

It  is  a  book,  however,  which  will  be  in  the  hands  of  almost  every  one  who  is  much  interested  in  pharma- 
ceutical operations,  as  we  know  of  no  other  publication  so  well  calculated  to  fill  a  void  long  felt.—  The  Medi- 
cal Examiner. 

The  country  practitioner  who  is  obliged  to  dispense  his  own  medicines,  will  find  it  a  most  valuable  assist- 
ant.— Monthly  Journal  and  Retrospect. 

The  book  is  strictly  practical,  and  describes  only  manipulations  or  methods  of  performing  the  numerous 
processes  the  pharmaceutist  has  to  go  through,  in  the  preparation  and  manufacture  of  medicines,  together 
with  all  the  apparatus  and  fixtures  necessary  thereto.  On  these  matters,  this  work  is  very  full  and  com- 
plete, and  details,  in  a  style  uncommonly  clear  and  lucid,  not  only  the  more  complicated  and  difficult  pro- 
cesses, hut  those  not  less  important  ones,  the  most  simple  and  common.  The  volume  is  an  octavo  of  five 
hundred  and  seventy-six  pages.  It  is  elegantly  illustrated  with  a  multitude  of  neat  wood  engravings,  and 
is  unexceptionable  in  its  whole  typographical  appearance  and  execution.  We  take  great  satisfaction  in 
commending  this  so  much  needed  treaiise.  not  only  to  those  for  whom  it  is  more  specially  designed,  but  to 
tne  medical  profession  generally— to  every  one.  who,  in  his  practice,  has  occasion  to  prepare,  as  well  as  ad- 
minister medical  agents. — Buffalo  Medical  Journal. 


JJTD    COMPLETE  J1LEDICJIL, 

MEDICAL"  BOTANY-, 

OR,  A  DESCRIPTION  OF  ALL  THE  MORE  IMPORTANT  PLANTS  USED  IN  MEDICINE,  AND 
OF  THEIR  PROPERTIES,  USES,  AND  MODES  OF  ADMINISTRATION, 

BY  R.  EGLESFELD  GRIFFITH,  M.  D.,  &c.  &c. 
In  one  large  8vo.  vol.  of  704  pages,  handsomely  printed,  with  nearly  350  illustrations  on  wood. 

One  of  the  greatest  acquisitions  to  American  medical  literature.  It  should  by  all  means  be  introduced  at 
the  very  earliest  period,  into  our  medical  schools,  and  occupy  a  place  in  the  library  of  every  physician  in  the 
land. — Southwestern  Medical  Advocate. 

Admirably  calculated  for  the  physician  and  student — we  have  seen  no  work  which  promises  greater  ad- 
vantages to  the  profession  .—N.  O.  Medical  and  Surgical  Journal. 

One  of  the  few  books  which  supply  a  positive  deficiency  in  our  medical  literature. —  Western  Lancet. 

We  hope  the  day  is  not  distant  when  this  work  will  not  only  be  a  text-book  in  every  medical  school  and 
college  in  the  Union,  but  find  a  place  in  the  library  of  every  private  practitioner. — N.  Y.  Journ.  of  Medicine. 

ELLIS' S  MEDICAL  FORMULARY Improved  Edition. 

THE  MEDICAL  FORMULARY: 

BEING   A   COLLECTION  OF  PRESCRIPTIONS,  DERIVED   FROVI  THE  WRITINGS  AND  PRACTICE  OF  MANY  OF  THB  MOST 
EMINENT   PHYSICIANS   OF    AMERICA    AND   EUROPE 

To  which  is  added  an  Appendix,  containing  the  usual  Dietetic  Preparations  and  Antidotes  for  Poisons. 

THE   WHOLK   ACCOMPANIED   WITH   A   FEW   BRIEF   PHARMACEUTIC   AND   MEDICAL    OBSERVATIONS. 

BY    BENJAMIN    ELLIS,    M.  D. 

KINTH  EDITIOX,  CORRECTED  AND   EXTENDED,   BY  SAMUEL  GEORGE  MORTON,   M.   D. 

In  one  neat  octavo  volume  of  268  pages. 


CARPENTER   ON  ALCOHOLIC  LIQUORS.-(A  New  Work.) 

A  Prize  Essay  on  the  Use  of  Alcoholic  Liquors  in  Health  and  Disease.     By  William  B.  Carpenter, 
M.  D.,  author  of  "  Principles  of  Human  Physiology,"  &c.     In  one  12mo.  volume. 


I 

30  BLANCHARD  &  LEA'S  PUBLICATIONS.— (Chemistry.) 

NEW    AND   IMPROVED    EDITION— (Just  Issued.) 

ELEMENTARY^  CHEMISTRY, 

THEORETICAL    AND    PRACTICAL. 
BY  GEORGE  FOWNES,  PH.  D., 

Chemical  Lecturer  in  the  Middlesex  Hospital  Medical  School,  &c.  &c. 

WITH   NUMEROUS   ILLUSTRATIONS. 
THIRD    AMERICAN,    FROM    A    LATE    LONDON    EDITION.      EDITED,  WITH   ADDITIONS, 

BY  EGBERT  BRIDGES,  M.  D., 

Professor  of  General  and  Pharmaceutical  Chemistry  iu  the  Philadelphia  College  of  Pharmacy,  &c.  &c. 
In  one  large  royal  12mo.  vol.,  of  over  500  pages,  with  about  180  wood-cuts,  sheep  or  extra  cloth. 

At  the  time  of  his  death,  Professor  Fownes  had  just  completed  the  revision  of  this  work  for  his 
third  edition,  and,  at  his  request,  Dr.  H.  Bence  Jones  undertook  the  office  of  seeing  it  through  the 
press,  and  making  such  additions  in  the  department  of  Animal  Chemistry  as  were  rendered  neces- 
sary by  the  numerous  discoveries  daily  making  in  that  branch  of  the  science.  The  task  of  the 
American  editor,  therefore,  has  merely  been  to  add  such  new  matter  as  may  since  have  appeared, 
and  to  adapt  the  whole  to  the  wants  of  the  American  student,  by  appending  in  the  form  of  notes 
such  points  of  interest  as  would  be  calculated  to  retain  the  position  which  the  original  has  so  justly 
obtained,  and  to  maintain  it  on  an  equality  with  the  rapid  advance  of  chemical  science.  It  will, 
therefore,  be  found  considerably  enlarged  and  greatly  improved.  Notwithstanding  its  increase  in 
size,  it  has  been  kept  at  its  former  extremely  low  price,  and  may  now  be  considered  as  one  of  the 

CHEAPEST  TEXT-BOORS  ON  CHEMISTRY  NOW  EXTANT, 

The  work  of  Dr.  Fownes  has  long  been  before  the  public,  and  its  merits  have  been  fully  appreciated  as 
the  best  text-book  on  Chemistry  now  in  existence.  W e  do  not,  of  course,  place  it  in  a  rank  superior  to  the 
•works  of  Brande,  Graham,  Turner,  Gregory,  or  Gmelin,  but  we  say  that,  as  a  work  for  students,  it  is  prefer- 
able to  any  of  them.—  London  Journal  of  Medicine. 

The  rapid  sale  of  this  Manual  evinces  its  adaptation  to  the  wants  of  the  student  of  chemistry,  whilst  the 
well  known  merits  of  its  lamented  author  have  constituted  a  guarantee  for  its  value,  as  a  faithful  exposition 
of  the  general  principles  and  most  important  facts  of  the  science  to  which  it  professes  to  be  an  introduction. 

We  have  only  to  add,  that  Dr.  Bence  Jones  appears  to  have  performed  his  editorial  ta*k  most  thoroughly, 
the  want  of  the  author's  final  supervision  being  nowhere  discoverable.—  The  British  and  Foreign  Medico- 
Chirurgical  Review. 

A  work  well  adapted  to  the  wants  of  the  student.  It  is  an  excellent  exposition  of  the  chief  doctrines  and 
facts  of  modern  chemistry,  originally  intended  as  a  guide  to  the  lecture?  of  the  author,  corrected  by  his  own 
hand  shortly  before  his  death  in  1849,  and  recently  revised  by  Dr.  Bence  Jones,  who  has  made  some  additions 
to  the  chapter  on  animal  chemistry.  Although  not  intended  to  supersede  the  more  extended  treatises  on 
chemistry,  Professor  Fownes'  Manual  may,  we  think,  be  often  used  as  a  work  of  reference,  even  by  those 
advanced  in  the  study,  who  may  be  desirous  of  refreshing  their  memory  on  some  forgotten  point.  The  size 
of  the  work,  and  still  more  the  condensed  yet  perspicuous  style  in  which  it  is  written,  absolve  it  from  the 
charges  very  properly  urged  against  most  manuals  termed  popular,  viz.,  of  omitting  details  of  indispensable 
importance,  of  avoiding  technical  difficulties,  instead  of  explaining  them,  and  of  treating  subjects  of  high  sci- 
entific interest  in  an  unscientific  way. — Edinburgh  Monthly  Journal  of  Medical  Science. 


BOWMAN'S  MEDICAL  CHEMISTRY- (Just  Issued.) 

PRACTICAL  HANDBOOK  OF  MEDICAL  CHEMISTRY. 

BY  JOHN  E.  BOWMAN,  M.  D. 

In  one  neat  volume,  royal  12mo.,  with  numerous  illustrations. 

We  cannot  too  highly  commend  the  very  elaborate,  yet  clear  and  distinct  manner,  in  which  the  appear- 
ances of  these  fluids,  and  their  variations  in  disease,  are  described.  To  the  practitioner,  the  book  is  specially 
recommended,  as  giving  a  very  clear  account  of  many  chemical  matters,  which  must  be  ever  coming  before 
him  in  his  daily  practice.  Every  practitioner,  and  every  student  of  clinical  medicine,  should  endeavor  to 
enrich  his  collection  of  books  with  Mr.  Bowman's  little  volume. — London  Journal  of  Medicine. 

Mr.  Bowman  has  succeeded  in  supplying  a  desideratum  in  medical  literature.  In  the  little  volume  before 
us,  he  has  given  a  concise  but  comprehensive  account  of  all  matters  in  chemistry  which  the  man  in  practice 
may  desire  to  know. — Lancet. 

BY  THE  SAME  AUTHOR- (Irately  Issued.) 

INTRODUCTION  TO  PRACTICAL  CHEMISTRY,  Including  Analysis, 

With  Numerous  Illustrations.    In  one  neat  volume,  royal  12m o. 
GARDNER'S  MEDICAL  CHEMISTRY. 

MEDICAL    C~HEMISTRY, 

FOR  THE  USE  OF  STUDENTS  AND  THE  PROFESSION; 

BEING  A  MANUAL   OF  THE   SCIENCE.    WITH   ITS  APPLICATIONS  TO  TOXICOLOGY, 
PHYSIOLOGY,  THERAPEUTICS,  HYGIENE,  &c. 

BY  D.  PEREIRA  GARDNER,  M.  D. 

In  one  handsome  royal  I2mo.  volume,  with  illustrations. 

New  Edition,  Preparing,— THE  ELEMENTS  OF  CHEMISTRY, 

INCLUDING  THE   APPLICATION    OF   THE  SCIENCE  TO   THE   ARTS.      WITH   NUMEROUS   ILLUSTRATIONS. 

BY    THOMAS    GRAHAM,  F.   R.  S.,  L.  E.  &  D. 

WITH  NOTES  AND  ADDITIONS   BY  ROBERT  BRIDGES,  M.  D.,  &c.  &c. 

SIMON'S  ANIMAL  CHEMISTRY,  with  Reference  to  the  Physiology  and  Pathology 
of  Man.     By  G.  E.  DAT.     One  vol.  8v«.,700  pages. 


L 


BLANCHARD  &  LEA'S  PUBLICATIONS.  31 

TAYLOR'S   JflEDIC,£L,    JTUR ISPR  UDEJTCE. 

MEDICAL     JURISPRUDENCE. 

BY  ALFRED  S.  TAYLOR, 

SECOND    AMERICAN,   FROM   THE   THIRD    AND    ENLARGED    LONDON    EDITION. 
With  numerous  Notes  and  Additions,  and  References  to  American  Practice  and  Law. 

BY  R.  E.  GRIFFITH,  M.  D. 

In  one  large  octavo  volume. 

This  work  has  been  much  enlarged  by  the  author,  and  may  now  be  considered  as  the  standard 
authority  on  the  subject,  both  in  England  and  this  country.  It  has  been  thoroughly  revised,  in 
this  edition,  and  completely  brought  up  to  the  day  with  reference  to  the  most  recent  investigations 
and  decisions.  No  further  evidence  of  its  popularity  is  needed  than  the  fact  of  its  having,  in  the 
short  time  that  has  elapsed  since  it  originally  appeared,  passed  to  three  editions  in  England,  and 
two  in  the  United  States. 

We  recommend  Mr.  Taylor's  work  as  the  ablest,  most  comprehensive,  and,  above  all,  the  most  practically 
useful  book  which  exists  on  the  subject  of  legal  medicine.  Any  man  of  sound  judgment,  who  has  mastered 
the  contents  of  Taylor's  "  Medical  Jurisprudence,"  may  go  into  a  court  of  law  with  the  most  perfect  confi- 
dence of  being  able  to  acquit  himself  creditably  .—Medico-  Chirurgical  Review. 

The  mo.*t  elaborate  and  complete  work  that  has  yet  appeared.  It  contains  an  immense  quantity  of  cases 
lately  tried,  which«g|ttle  it  to  be  considered  what  Beck  was  in  its  day. — Dublin  Medical  Journal. 


TAYLOR    ON    POISONS. 

N    P  Ol  S  O  N  S, 

IN  RELATION  TO  MEDICAL  JURISPRUDENCE  AND  MEDICINE, 

BY  ALFRED  S.  TAYLOR,  F.  R.  S.,  &c. 

EDITED,  WITH  NOTES  AND  ADDITIONS,  BY  R.  E.  GRIFFITH,  M.  D. 

In  one  large  octavo  volume,  of  688  pages. 

The  most  elaborate  work  on  the  subject  that  our  lite ratu  re possesses.  —  Brit,  and  For.  Medico- Chirur.  Review. 
'    One  of  the  most  practical  and  trustworthy  works  on  Poisons  in  our  language. —  Western  Journal  of  Med. 
It  contains  a  vast  body  of  facts,  which  embrace  all  that  is  important  in  toxicology,  all  that  is  necessary  to 
the  guidance  of  the  medical  jurist,  and  all  that  can  be  desired  by  the  lawyer. — Medico- Chirurgical  Review. 

It  is.  so  far  as  our  knowledge  extends,  incomparably  the  best  upon  the  subject;  in  the  highest  degree  credit- 
able to  the  author,  entirely  trustworthy,  and  indispensable  to  the  student  and  practitioner. — N.  Y.  Annalist. 

BEALE    ON    HEALTH-JUST    READY, 

THE  LAWS  OF  HEALTH  IN  RELATION  TO  MIND  AND  BODY. 

A    SERIES    OP    LETTERS    FROM    AN    OLD    PRACTITIONER    TO    A    PATIENT. 

BY  LIONEL  JOHN  BEALE,   M.  R.  C.  S..,  &c. 

In  one  handsome  volume,  royal  I2mo.,  extra  cloth. 

The  "Laws  of  Health,"  in  relation  to  mind  and  body,  is  a  book  which  will  convey  much  instruction  to 
non-protessi  nal  readers;  they  may,  from  these  letters,  glean  the  principles  upon  which  young  persons 
should  be  educated,  and  derive  much  useful  information,  which  will  apply  to  the  preservation  of  health  at 
all  ages.— Med.  Times. 


D  U  I  R 


GREGORY  ON  ANIMAL  MAGNETISM— (Now 

LETTERS    TO    A   CANDID    ENQ  UTR  E  R 

ON    ANIMAL    MAGNETISM, 

DESCRIPTION  AND  ANALYSIS  OF  THE  PHENOMENA,    DETAILS  OF  FACTS  AND  CASES, 
BY  WILLIAM  GREGORY,  M.  D.,  F.  R.  S.  E., 

Professor  of  Chemistry  in  the  University  of  Edinburgh,  &c. 
In  one  neat  volume,  royal  12mo.,  extra  cloth. 

TRANSACTIONS    OF    THE 

AMERICAN   MEDICAL   ASSOCIATION, 

VOLUME  I.  FOR  1848,  VOL.  II.  FOR  1849,  VOL.  III.  FOR  1850. 

Large  octavo,  extra  cloth,  or  paper  covers  for  mailing. 
Any  volume  gold  separate,  or  tlie  whole  in  setg  at  a  reduced  price. 

95-  Orders  for  the  supply  of  Medical  Societies  should  be  sent  direct  to  the  Treasurer  of  the  As- 
sociation, Isaac  Hays,  M.  D.,  care  of  Blanchard  &  Lea,  with  the  amount  enclosed. 

DUNGLISON  ON  HUMAN  HEALTH— HUMAN  HEALTH,  or  the  Influence  of  Atmosphere  and  Locality, 
Change  of  Air  and  Climate,  Seasons.  Food,  Clothing,  Bathing,  Exercise,  Sleep.  &c.  &c.  &c..  on  healthy 
man;  constituting  Elements  of  Hygiene.  Second  edition,  with  many  modifications  and  additions.  By 
Rob  ley  Dunglison,  M.  D  .  &c.  &c.  In  one  octavo  volume  of  464  pages. 

DUNGLISON'S  MEDICAL  STUDENT.— '1 'he  Medical  Student,  or  Aids  to  the  Study  of  Medicine.  Revised 
and  Modified  Edition.  1  vol.  royal  12mo..  extra  cloth.  312  pp. 

BARTLKTT'S  PHILOSOPHY  OF  MEDICINE.— An  Essay  on  the  Philosophy  of  Medical  Science  In 
one  handsome  8vo  volume.  312  pp. 

ARTLEl'T  ON  CERTAINTY  IN  MEDICINE.— An  Inquiry  into  the  Degree  of  Certainty  in  Medicine, 
and  into  the  Nature  and  Extent  of  its  Power  over  Disease.    In  one  vol.  royal  12mo.    84  pp. 


32  BLANCHARD  &  .LEA'S  PUBLICATIONS. 

NEW  AND  ENtA-RGED  EDITION— (tatey  Issued.) 

MEDIC  AL  "LEXICON ; 

A    DICTIONARY    OF   MEDICAL    SCIENCE, 

CONTAINING 

CONCISE  EXPLANATIONS  OF  THE  VARIOUS  SUBJECTS  AND  TERMS,  WITH 

THE  FRF:NCH  AND  OTHER  SYNONYMES;  NOTICES  OF  CLIMATE  AND 

OF  CELEBRATED  MINERAL  WATERS:  FORMULA  FOR  VARIOUS 

OFFICINAL  AND  EMPIRICAL  PREPARATIONS,  ETC. 

BY  ROBLEY  DUNGLISON,  M.  D.,  &c. 

SEVENTH  EDITION, 

CAREFULLY  REVISED  AND  GREATLY  ENLARGED. 

In  One  very  large  and  beautifully  printed  Octavo  Volume  of  over  Nine  Hundred  Pages,  closely  printed 
in  double  columns.     Strongly  bound  in  leather,  with  raised  bands. 

This  edition  is  not  a  mere  reprint, of  the  last.  To  show  the  manner  in  which  the  author  has  la- 
bored to  keep  it  up  to  the  wants  of  the  day,  it  may  be  stated  to  contain  over  SIX  THOUSAND 
WORDS  AND  TERMS  more  than  the  fifth  edition,  embracing  altogether  satisfactory  definitions  of 

OVER    FORTY-FIVE    THOUSAND    WORDS. 

Every  means  has  been  employed  in  the  preparation  of  the  present  edition,  to  render  its  me- 
chanical execution  and  typographical  accuracy  in  every  way  worthy  its  extended  reputation  and 
universal  use.  The  size  of  the  page  has  been  enlarged,  and  the  work  itself  increased  more  thaa 
a  hundred  pages;  the  press  has  been  watched  with  great  care;  a  new  font  of  type  has  been  used, 
procured  for  the  purpose;  and  the  whole  printed  on  fine  clear  white  paper,  manufactured  expressly 
for  it.  Notwithstanding  this  marked  improvement  over  all  former  editions,  the  price  is  retained 
at  the  original  low  rate,  placing  it  within  the  reach  of  all  who  may  have  occasion  to  refer  to  its 
pages,  and  enabling  it  to  retain  the  position  which  it  has  so  long  occupied,  as 

THE  STANDARD  AMERICAN  MEDICAL  DICTIONARY. 

This  most  complete  medical  Lexicon—certainly  one  of  the  best  works  of  the  kind  in  the  language. — 
Charleston  Medical  Journal. 

The  most  complete  Medical  Dictionary  in  the  English  language. —  Western  Lancet. 

Familiar  with  nearly  all  the  medical  dictionaries  now  in  print,  we  consider  the  one  before  us  the  most 
complete,  and  an  indispensable  adjunct  to  every  medical  library. — British  American  Medieal  Journal. 

Admitted  by  all  good  judges,  both  in  this  country  and  in  Europe,  to  be  equal,  and  in  many  respects  superior 
>  any  other  work  of  the  kind  yet  published. — Northwestern  Medical  and  Surgical  Journal. 

The  most  comprehensive  and  best  English  Dictionary  of  medical  terms  extant. — Buffalo  Med.  Journal, 


MANUALS   FOR   EXAMINATION— (Lately  Issued.) 

AN  ANALYTICAL  COMPENDIUM 

OF  THE  VARIOUS  BRANCHES  OF  MEDICAL  SCIENCE, 

FOE  THE  USE  AND  EXAMINATION  OF  STUDENTS. 
BY  JOHN  NEILL,  M.  D., 

AND 

FRANCIS  GURNEY  SMITH,  M.  D., 

Forming  one  very  large  and  handsomely  printed  volume  in  royal  duodecimo,  of  over  900  large  pages, 
with  about  350  wood  engravings,  strongly  bound  in  leather,  with  raised  bands. 

Taking  the  work  before  us.  we  can  certainly  say  that  no  one  who  has  not  occupied  himself  with  the 
different  scientific  treatises  and  essays  that  have  appeared  recently,  and  has  withal  a  rare  memory,  could 
pretend  to  possess  the  knowledge  contained  in  it;  and  hence  we  can  recommend  it  to  such — as  well  as  to 
students  especially — for  its  general  accuracy  and  adequacy  for  their  purposes;  and  to  the  well-informed 
practitioner  to  aid  him  in  recalling  what  may  easily  have  passed  from  his  remembrance.  We  repeat  our 
favorable  impression  as  to  the  value  of  this  book,  or  series  of  books;  and  recommend  it  as  decidedly  useful 
to  those  especially  who  are  commencing  the  study  of  their  profession. —  The  Medical  Examiner. 

We  have  no  hesitation  in  recommending  it  to  students.—  Southern  Medical  and  Surgical  Journal. 

We  recommend  this  work  especially  to  the  notice  of  our  junior  readers. — London  Medical  Gazette. 


HOBLYN'S   MEDICAL   DICTIONARY. 

A  DICTIONARY  OF  THE  TERMS  USED  IN  MEDICINE 

AND   THE   COLLATERAL    SCIENCES. 
BY  RICHARD   D.   HOBLYN,  A.  M.,  OXON. 

REVISED,  WITH  NUMEROUS  ADDITIONS,  FROM  THE  SECOND  LONDON  EDITION, 
BY  ISAAC  HAYS,  M.  D.,  Sic.     In  one  large  royal  12mo.  volume  of  402  pages,  double  columns. 

We  cannot  too  strongly  recommend  this  small  and  cheap  volume  to  the  library  of  every  student  and  prac- 
titioner.— Medico-Chirurgical  Review. 


